Ask Mac – Questions ListCategory: BronchoconstrictionWhy can’t we administer epi to a patient with asthma exacerbation who become VSA?
asked 3 years ago
I was wondering recently while reviewing my re-cert material why it is that if asthma exacerbation is the reason for a pt. becoming VSA why 0.5 mg of epi IM would not be administered while preparing for iv in a similar fashion that epi is used for anaphylaxis if it is the causative reason a pt. becomes VSA. Thanks for the help.
1 Answers
answered 3 years ago
Possible reasons for this would include that the etiology for patients arresting from asthma is generally hypoxia and IM epi is not necessarily particularly helpful in that regard. In anaphylaxis however, epinephrine has so many therapeutic properties that it should not be withheld; one of the rare “silver bullets” in medicine. It is entirely possible that a patient who is arrested from anaphylaxis may be in PEA and but actually have some forward flow and pulses are just not palpable. Given the role of epinephrine in mitigating the anaphylaxis cascade, epinephrine should not be withheld.
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