When is epinephrine indicated for EMS patients?

• A. Only for asthma
• B. For anaphylaxis or severe allergic reaction with airway compromise or shock
• C. For chest pain
• D. For hypoglycemia

Answer: (B)

Epinephrine is indicated in EMS for anaphylaxis or a severe allergic reaction with airway compromise or shock. In these situations, mediators cause airway swelling, bronchospasm, and a dangerous drop in blood pressure. Epinephrine acts on alpha-1 receptors to constrict blood vessels and reduce edema, on beta-1 receptors to help increase heart output, and on beta-2 receptors to relax bronchial smooth muscle. This combination quickly improves breathing and stabilizes circulation, which is why this is the treatment choice in the field. It isn’t used for isolated asthma without signs of a systemic reaction, nor for chest pain or hypoglycemia, where other specific therapies are more appropriate.