外國 WMAI 的 Wilderness Medicine Field Protocols 話可以在過敏性休克 (Protocol 1) 和嚴重哮喘 (Protocol 6) 時注射腎上腺素 ( http://www.wildmed.com/pdf/WMA-Field-Protocols.pdf )。而其它外國的急救課程都有教 Epipen 這類課題,例如 2010 AHA & ARC Guidelines for First Aid. Part 17: First Aid 中有講到: "Anaphylaxis... First aid providers should be familiar with the epinephrine auto-injector so that they can help a victim with an anaphylactic reaction to self-administer it. First aid providers should also know how to administer the auto-injector if the victim is unable to do so, provided that the medication has been prescribed by a physician and state law permits it (Class IIb, LOE B) " ( http://circ.ahajournals.org/content/122/18_suppl_3/S934.full).