There may be instances where firefighters or police officers are the first responders on scene for a patient in cardiac arrest secondary to suspected anaphylaxis. In these situations, first responders should consider the following:

1. Did the patient have clear signs and symptoms consistent with anaphylaxis prior to arrest.

2. Is the patient vital signs absent (VSA) and the cardiac arrest is suspected to be the result of anaphylaxis.

3. Is an epinephrine auto-injector readily available.

First responders who are trained and authorized to administer epinephrine auto-injectors may provide one dose of epinephrine via auto-injector, provided that doing so does not delay or interfere other critical resuscitation measures.

As a reminder, in the setting of cardiac arrest, the primary focus must remain on delivering high-quality CPR, providing effective ventilations, and ensuring early defibrillation as required. These interventions have the greatest impact on patient outcomes and should never be delayed while attempting to administer an epinephrine auto-injector. The administration of epinephrine, when appropriate, should be integrated into the resuscitation effort without interrupting or compromising these priority interventions.