EMTs and Epinephrine
One of FAAN’s ongoing initiatives is to help ensure that all ambulances are equipped with epinephrine and that all levels of emergency medical technicians (EMTs, or 911 personnel) are fully authorized to administer the medication during an anaphylactic emergency. Although we’ve made considerable progress since the late 1990s, there is still much work to be done.
States generally have three types of EMTs: Basics, Intermediates, and Paramedics. Basics are usually the most numerous.
Depending on where you live, EMT-Basics may not have access to epinephrine and/or may not be able to administer the medication in the field. Instead, Basics may be allowed only to “assist” in administering a person’s own prescribed epinephrine device.
Such a policy overlooks the possibility that an individual’s prescribed epinephrine may be unavailable at the time of a reaction. In such a situation, EMT-Basics responding to an anaphylactic emergency would be forced to transport the individual to the nearest hospital or call for EMT-Paramedic or EMT-Intermediate backup. Either scenario delays treatment and could result in tragedy.
See our map (.bmp ~878 KB) classifying EMT coverage by state.* This classification, though based on correspondence between FAAN and state emergency medical services agencies, should not be considered absolutely precise, because decisions pertaining to EMTs often vary within each state.
If you live in a needs improvement or locality-dependent state,
contact your local ambulance provider and ask whether (1) all ambulances are equipped with epinephrine, and in what form (autoinjector, vial and syringe), and (2) whether all types of EMTs (specifically, EMT-Basics) are authorized to use epinephrine in the field.
If you live in a good coverage state,
we still recommend that you contact your local ambulance service and ask the questions above. It never hurts to confirm your local coverage!
Report what you find out to FAAN by sending an email to advocacy@foodallergy.org.
*
In the case of Delaware and Hawaii, EMT-Basics are not allowed to carry and administer epinephrine; however, because these states are small, Advanced Life Support (ALS) ambulances staffed by Paramedics cover virtually the entire area. In the case of Vermont, EMT-Basics are permitted, in extenuating circumstances, to administer epinephrine with appropriate medical control.
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