How to treat anaphylaxis with epinephrine
Other platforms explain it with text and video. In VMS you practice it on the patient.
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
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]
Call for help
Call for advanced help and remove the trigger if possible (stop an infusion, remove a stinger). [1]
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]
Position
Lying with legs raised if dizzy or low blood pressure; sitting up if breathing is hard. Do not stand the patient up. [1]
Oxygen and monitoring
High-flow oxygen, saturation, blood pressure and heart rate. [1]
Repeat if needed
Repeat epinephrine every 5 to 15 minutes if symptoms do not improve, per protocol. [1]
Watch and transport
Symptoms can return hours later. Every patient who needed epinephrine goes to the hospital. [1]
Common errors
- Giving antihistamines first and waiting.
- Injecting into the arm instead of the thigh.
- Standing the patient up.
Practice it in VMS
In VMS 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.
VMS cases that train this skill
Sources
Facts and steps follow NASEMSO National Model EMS Clinical Guidelines. VMS is not affiliated with these organizations. Updated: 2026-10-11.