Volume 29, Issue 160, June 2025

Epinephrine use in the emergency department for anaphylaxis management: Systematic review

Mazi Mohammed Alanazi^1♦, Raghad Naif Alshareef², Bakheet Atiah Alghamdi²

¹Saudi and Jordanian Board Emergency Medicine, Head of Emergency Research Unit, Emergency Department, First Health Cluster, Riyadh, Saudi Arabia
²Saudi Board Emergency Medicine Resident, Emergency Department, First Health Cluster, King Saud Medical City, Riyadh, Saudi Arabia

^♦Corresponding author
Mazi Mohammed Alanazi, Saudi and Jordanian Board Emergency Medicine, Head of Emergency Research Unit, Emergency Department, First Health Cluster, Riyadh, Saudi Arabia

ABSTRACT

Our study's goal was to evaluate the usage of epinephrine in ED patients who experienced anaphylaxis. Evaluate the route of administration (intravenous, intramuscular, subcutaneous); determine whether epinephrine was used as an initial treatment to manage anaphylaxis; and determine whether there is a correlation between the dose used and the frequency of cardiovascular adverse events. The Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guideline was followed in the conduct of this investigation. We located publications that addressed the use of epinephrine to treat ANA in the ED by searching PubMed, Scopus, and the Web of Science Core Collection. A language limitation was applied in order to include articles published in English. The publication date limitation was applied only to articles published between 2010 and 2024. To minimize the risk of missing any pertinent citations, we also thoroughly reviewed the reference lists of the original papers included. We found that the risk of overdosing and serious cardiovascular events is significantly increased when administering an intravenous adrenaline bolus. The results of this study supported the safety of intramuscular epinephrine and the need for more awareness and further instruction on IV bolus epinephrine in ANA patients. In order to manage anaphylactic responses, it is recommended that emergency department staff undergo educational training on proper epinephrine administration.

Keywords: Epinephrine, emergency department, anaphylaxis

Medical Science, 2025, 29, e86ms3592

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DOI: https://doi.org/10.54905/disssi.v29i160.e86ms3592

Published: 18 June 2025