Per the Region 3 Regional Physicians Advisory Board (RPAB), and the Greater Miami Valley EMS Council Medical Director, Dr. Marriott, the following Just in Time Standing Order is being issued and is in effect now.  EpiPen Jr is currently unavailable nationwide, and our regional supplies have or soon will expire. A nationwide shortage of Adult EpiPens is also imminent. 

---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

 

EMR and EMT:       WHEN EpiPen Jr. or EpiPen IS NOT AVAILABLE

 

·         < 15 kg; call Medical Control

·         For all others use Adult EpiPen

·         If Adult EpiPen unavailable, call Medical Control

·         EMRs and EMTs can still assist with administration of the patient's own EpiPen or EpiPen Jr EpiPen either adult or junior

 

Advanced and Paramedic:      WHEN EpiPen Jr. or EpiPen IS NOT AVAILABLE

·         < 15 kg; use EpiPen Jr OR (1:1000) 0.01 mg/kg IM

·         > 15 kg and < 30 kg; use Adult EpiPen OR Epi (1:1000) 0.01 mg/kg IM

·         May repeat Epi (1:1,000) 0.01 mg/kg IM (max 0.5 mg) after 5 minutes.

·         >30 kg; use Adult EpiPen AND an additional 0.2 mg of Epi (1:1000) IM for a total of 0.5 mg IM OR Epi (1:1000) 0.5 mg IM

·         May repeat Epi (1:1,000) 0.5 mg IM after 5 minutes

·         AEMTs and Paramedics can still assist with administration of the patient's own EpiPen or EpiPen Jr