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Emergencies and resuscitation

How to treat anaphylaxis with epinephrine

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

EMS (NREMT)Nursing (NCLEX)MD / DOPA
Practice it in VR with Blocky

Epinephrine is the first and most important drug in anaphylaxis. Delay is the main cause of death, so give it as soon as you recognize the reaction.

Step by step

  1. Recognize it

    Sudden skin or mouth symptoms (hives, swelling) with trouble breathing, low blood pressure, or vomiting and cramps, often after a known trigger. [1]

  2. Call for help

    Call for advanced help and remove the trigger if possible (stop an infusion, remove a stinger). [1]

  3. Give epinephrine IM

    Into the outer thigh. Adult auto-injector 0.3 mg; child auto-injector 0.15 mg for smaller children. With a vial, 1 mg/mL at 0.01 mg/kg up to 0.5 mg in adults, per protocol. [1]

  4. Position

    Lying with legs raised if dizzy or low blood pressure; sitting up if breathing is hard. Do not stand the patient up. [1]

  5. Oxygen and monitoring

    High-flow oxygen, saturation, blood pressure and heart rate. [1]

  6. Repeat if needed

    Repeat epinephrine every 5 to 15 minutes if symptoms do not improve, per protocol. [1]

  7. Watch and transport

    Symptoms can return hours later. Every patient who needed epinephrine goes to the hospital. [1]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

34 Making Synapses cases train this skill: open the case library

Sources

  1. NASEMSO National Model EMS Clinical Guidelines

Facts and steps follow NASEMSO National Model EMS Clinical Guidelines. Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.