[Shav779]

Wouldn't a needle be better as it allows it to be administered to a non-breathing patient vs a nasal spray which presumably only works when the patient is breathing? I have to assume that with anaphylaxis it is a reasonable likelihood that you're dealing with a non-breathing patient.

[sweca]

The patient does not need to be actively inhaling, even though it's recommended. There's enough pressure that the nasal spray will spring up into the nasal mucosa to be absorbed into the blood.