Understanding the Role EpiPens Play in Urban and Wilderness Settings

By NCOAE Headquarters April 29, 2021

Wilderness Medicine Training

For those who suffer severe allergic reactions to everything from wasp stings to wheat consumption, getting help — and getting that medical intervention fast — may mean the difference between life and death.

Here at The National Center for Outdoor & Adventure Education (NCOAE), we train our Emergency Medical Technician (EMT) students and Wilderness First Responder (WFR) students in the use of EpiPen, an autoinjector for those suffering a sudden anaphylaxis reaction.

This somewhat imposing emergency medicine tool is an injection device that contains epinephrine, a chemical that narrows blood vessels and opens airways in the lungs. A promptly administered injection may reverse severe low blood pressure, a rash or itchy skin, an alarming shortness of breath, hives, nausea, vomiting, and other symptoms of an allergic reaction.

Anaphylaxis is a life-threatening allergic reaction that requires immediate treatment, whether within the city limits or deep in the backcountry.

And while most anaphylaxis reactions are mild and self-limiting, it is impossible to predict — at least in the beginning — whether a reaction will become life-threatening. As a result, rapid intervention is always critical. A hiker’s risk for anaphylaxis increases if they suffer asthma that is severe or not controlled. Medical conditions such as heart disease can also increase the risk of an episode.

What can trigger an anaphylaxis episode?

The following are among of the most common causes of anaphylaxis:

  • Milk, peanuts, tree nuts, eggs, shellfish, wheat, and soy
  • Stings from bees, wasps, or fire ants
  • Antibiotics, NSAIDs, or aspirin
  • Latex

Adrenaline is the first line treatment for anaphylaxis and is most often administered using an autoinjector such as the EpiPen or drawn from a vial using a needle and syringe. EpiPen autoinjectors are available in two sizes — one for young children and another for those weighing more than 66 pounds. Since epinephrine is a prescription medication, anyone with a history of severe allergic reactions should have a prescription and the device at hand. 

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