Question

87. As you are taking your stretcher out from the emergency department to your unit, a woman is seen assisting a man out of the car. As you move to assist the man, he

collapses into your arms. His skin is mottled and he is wheezing audibly. The wife says she thinks her husband is having a heart attack after receiving a bee sting. Your partner
approaches with an Epipen to administer to the patient. The IM epinephrine most likely will be ineffective because:
His heart may not be pumping.
It doesn't work on large people.
Too much histamine is in his system.
The peripheral circulation is shut down.

Answer 1

The IM epinephrine is likely ineffective because the peripheral circulation is shut down during severe anaphylactic shock, potentially preventing the medication from reaching its target.

Step-by-step explanation:

The IM epinephrine most likely will be ineffective because the peripheral circulation is shut down. In a severe allergic reaction, such as anaphylaxis triggered by a bee sting, there is systemic mast cell degranulation that causes a severe drop in blood pressure and contractions of the bronchial smooth muscle. When the skin is mottled, and the patient is wheezing audibly, it is indicative of anaphylactic shock. The wheezing and changes in skin condition are symptoms of this systemic reaction, which can rapidly progress and become fatal if not properly treated.

Epinephrine acts by raising blood pressure and relaxing the bronchial smooth muscles, which can be lifesaving during anaphylactic shock. However, if the patient's heart may not be pumping effectively, or the peripheral circulation has been compromised, the medication may not reach its intended target. Individuals with known severe allergies are advised to always carry an epinephrine injector like an EpiPen®, which can rapidly administer the drug and is crucial for providing immediate treatment until medical care can be accessed.