Epipens, their use and possible dangers

[VEG]

you are correct but some that have them seem willing to jab someone else with them.

 

[BeeJayBee]

I was under the impression you can't administer it to someone if it isn't prescribed to them anyway and that is only in dire emergency and if there is noone qualified able to administer within a sensible time frame. As far as I'm aware it isnt legal to have them in a first aid kit unless you are medically trained to the appropriate level anyway.

Although not quite the same level, but I do know people who will happily offer 'leftover' antibiotics to other people.

 

[alanf]

It's largely dependent on how much responsibility an individual is expected to assume for their own actions. In Canada, for instance, Epipens are available over the counter of a pharmacy, no prescription, no medical assessment. The individual is responsible for their own actions. As they would be with a knife, chainsaw or driving a vehicle.

Many airlines carry them, as they do other medication, because they may be needed. They would not be administered lightly and ultimately it's better to have something available than not.

If there is a situation where an Epipen would help, there is one to hand and regular paramedic aid is some time away, then I'd trust most responsible adults to make a considered decision. Mostly I'd expect that decision to be right, or at least the balance of decisions to be doing more good than harm. That a small number of cases might be called wrongly would not concern me about having them more freely available.

 

[REDWOOD]

It's largely dependent on how much responsibility an individual is expected to assume for their own actions. In Canada, for instance, Epipens are available over the counter of a pharmacy, no prescription, no medical assessment. The individual is responsible for their own actions. As they would be with a knife, chainsaw or driving a vehicle.

Many airlines carry them, as they do other medication, because they may be needed. They would not be administered lightly and ultimately it's better to have something available than not.

If there is a situation where an Epipen would help, there is one to hand and regular paramedic aid is some time away, then I'd trust most responsible adults to make a considered decision. Mostly I'd expect that decision to be right, or at least the balance of decisions to be doing more good than harm. That a small number of cases might be called wrongly would not concern me about having them more freely available.

but some sort of training should be given and made aware of the stages of AS and at what stage it should be given if an ambulance cant get there on time. Sticking a massive needle in your leg is bloody Painful and for someone to do this to you unnecessarily I think I would kill them. You can't teach common sense you are either born with it or not

 

[AnotherNewBee]

I would have no problem with anyone sticking an epipen in my leg if it was necessary to save my life. I would, of course, thank him for it.

If, however, misdiagnosis and over-enthusiasm led to the unnecessary administration of any drug which led to further problems I would be seriously annoyed. I'm sure my other half would be more than a little annoyed, too, if misuse of an epipen led to my death.

 

[earthsoul]

As a qualified nurse I would use and epi pen on someone if they were carrying it with no qualms.
I am concerned that people may hold off using one for fear of injuring someone.
I believe if you are teaching bee keeping then a basic understanding of anaphylaxis is a necessity, and my belief is also that injecting an epi pen in another unaffected HEALTHY person may make them a bit jittery and increase their heart rate but other wise would do very little harm. I believe it is better to over react that under react.
The difficulty is when you have a person who already has an underlying cardiac condition, BUT again if the choice is between a closed airway, which would cause a quick death, and a paramedic and later hospital sorting out the effects of adrenaline on a live person I know what I would do.
Before we got into the world of litigation this would have been fine, but now I also know that if I do inject a person with adrenaline I may end up facing litigation even if I did save their life.

 

[itma]

As a qualified nurse I would use and epi pen on someone if they were carrying it with no qualms.
...
Before we got into the world of litigation this would have been fine, but now I also know that if I do inject a person with adrenaline I may end up facing litigation even if I did save their life.

I don't think anyone should have any qualms about sticking someone with the victim's own epipen.

The only 'debate' concerns those who would either use their own, or someone else's, epipen on a third party.
As you say, regardless of the outcome, they would be wide open to litigation.

 

[VEG]

As a qualified nurse I would use and epi pen on someone if they were carrying it with no qualms.
I am concerned that people may hold off using one for fear of injuring someone.
I believe if you are teaching bee keeping then a basic understanding of anaphylaxis is a necessity, and my belief is also that injecting an epi pen in another unaffected HEALTHY person may make them a bit jittery and increase their heart rate but other wise would do very little harm. I believe it is better to over react that under react.
The difficulty is when you have a person who already has an underlying cardiac condition, BUT again if the choice is between a closed airway, which would cause a quick death, and a paramedic and later hospital sorting out the effects of adrenaline on a live person I know what I would do.
Before we got into the world of litigation this would have been fine, but now I also know that if I do inject a person with adrenaline I may end up facing litigation even if I did save their life.

How would you know they are healthy by just looking at them?

 

[earthsoul]

Exactly, which is why I phrased it that way, you don't.

 

[hedgerow pete]

sorry people but i am still on the shooting side here, i have done the epi pen day course with the saint john people and if i find YOUR epi pen on YOU with confidence i would use it,

the idea of someone going out and talking a quack into letting them get an epi pen to go around and inject anyone they seam fit or rather unfit is to me way past dangerous, if anyone came near me with an epi pen i would hope to high heaven it was a qualified quack or a paramedic, rather than a "helpfull" beekeeper

 

[victor meldrew]

Hi Pete ,
I had a dear friend who was (not once but twice ) torpedoed during WW11!
He , on overhearing some kids at works discussing being atheists ! leaned over to me and quietly said ( In a Lancashire accent of course )" Al tell thi what ! there's no atheists in a lifeboat"
I sincerely hope, that in the unfortunate position of suffering from an unexpected incidence of anaphylaxia , some one has the balls to administer a proven life maintaining auto injection to keep you going until the rescue services arrive !.
Epipen now issue 'twin packs' the second to be deployed if the first doesn't work quickly enough .
In rare individuals, this maybe counter productive !
However , should a person display the classic symptoms of true anyphalaxia, regardless of under lying medical conditions .
The balance of risk must weigh in favour of administration rather simply allowing the victim to die (rather than one having a clear conscience )
IMHO.
VM

 

[MartinL]

In Canada, for instance, Epipens are available over the counter of a pharmacy, no prescription, no medical assessment. ..............................
Many airlines carry them, as they do other medication, because they may be needed..

Is there a national Health Service in Canada?

All airlines carry them as a matter of necessity, difficult for the Paramedics to get the Ambulance off the ground in 15 mins, + more likely for other allergies (nuts)!

 

[beestie]

I had a dear friend who was (not once but twice ) torpedoed during WW11!
He , on overhearing some kids at works discussing being atheists ! leaned over to me and quietly said ( In a Lancashire accent of course )" Al tell thi what ! there's no atheists in a lifeboat"
I sincerely hope, that in the unfortunate position of suffering from an unexpected incidence of anaphylaxia , some one has the balls to administer a proven life maintaining auto injection to keep you going until the rescue services arrive !.
Epipen now issue 'twin packs' the second to be deployed if the first doesn't work quickly enough .
In rare individuals, this maybe counter productive !
However , should a person display the classic symptoms of true anyphalaxia, regardless of under lying medical conditions .
The balance of risk must weigh in favour of administration rather simply allowing the victim to die (rather than one having a clear conscience )
IMHO.
VM[/QUOTE]


I have witnessed a heart attack victim being administered large doses of adrenaline and defibrillation. The victim was not in a position to answer questions or fill in forms with regard to underlying medical conditions. The paramedics were simply doing what they could, at the time and given the circumstances, to keep the patient alive with what was available. The fact that the patient did not survive is of no consequence. The poor assembled family were very grateful to the paramedics for doing whatever they could.

Epipens are surely a last ditch attempt to keep someone alive who clearly would be collapsing from severe anaphylaxis. You don't need to be trained in anaphylaxis or even know how to spell it; if paramedics/ambulances/hospitals are too far away to be able to respond to collapse in good time, a shot of Epinephrine is a pretty good bet. What's the betting that a 999 call from a mobile phone following collapse after a sting would prompt the question 'Do you have an Epipen available?'

 

[drstitson]

"medically trained to the appropriate level"

my level 2 in doctoring trumps your level 1!

 

[picton farm]

Well well well, lots of strong opinions as usual!
My husband and I both have epipens JUST IN CASE but we were both given them for different reasons.
My husband had a severe reaction to some beestings a couple of years ago but it wasnt anaphalaxis, However the GP was concerned that as we still have bees in our meadow he may be stung and have a worse reaction. He has been stung many times in the last couple of years with no reaction at all but two weeks ago we were coming away from feeding some hives and he got a bee in his shoe.
By the time he realised, we were in the van driving home. It stung him and he went grey and clammy and stared to scratch his palms and talk gibberish. I managed to get him to take 2 piriton straight away but they take half an hour to kick in.
We were home in about 3 minutes and he got out of the van and vomited. I got him inside and called the doc who was irritated that we hadnt had the sense to use the pen already. By this time around ten minutes had passed since he was stung and he was very grey and uncommunicative. He was unable to use the pen himself so I did it for him. Within 3 minutes he was looking much better and able to talk again.
The doc said that it should have been used as soon as he started to feel giddy and sick..... that all over itching and vomiting is a severe enough allergy to merit the use of a pen. He suggested that feeling very sick was enough to constitute an allergic reaction.
I am sorry Pete, but for once I have to disagree with you. No doc will give an epipen without training and a good reason. However they will give them to you JUST IN CASE if you have ever shown a big reaction to a sting.

Epipens need replacing every 8 months or so and need to be stored in a cool place. We were lucky ours was ok because it was two months out of date but as we hadnt taken it seriously enough it had been stored in the bathroom cabinet in the cold.
Now we make sure we always carry them just in case it happens again.

 

[picton farm]

After seeing the size of the needle and the bruise it made, and putting up with the moaning about his sore leg for four days afterwards, I am not sure how easy I would find it to inject myself if I had to. The needle looks like a cannula! Having a partner trained to use it on you is probably a sensible idea because a severe reaction can certainly render you incapable of making your own decisions.
Once the doc said he needed the pen, he consented but he couldnt do it himself.

Afterwards the GP said that we should call 999 immediately if we are in any doubt what to do in future.

I imagine that if we had someone else here who was having a severe reaction and we called 999 for help we would respond to whatever the paramedic told us to do. If we have the epipen with us then it could save a life if the ambulance is a long way away but only if we were told to administer it.

 

[REDWOOD]

Hi Pete ,
I had a dear friend who was (not once but twice ) torpedoed during WW11!
He , on overhearing some kids at works discussing being atheists ! leaned over to me and quietly said ( In a Lancashire accent of course )" Al tell thi what ! there's no atheists in a lifeboat"
I sincerely hope, that in the unfortunate position of suffering from an unexpected incidence of anaphylaxia , some one has the balls to administer a proven life maintaining auto injection to keep you going until the rescue services arrive !.
Epipen now issue 'twin packs' the second to be deployed if the first doesn't work quickly enough .
In rare individuals, this maybe counter productive !
However , should a person display the classic symptoms of true anyphalaxia, regardless of under lying medical conditions .
The balance of risk must weigh in favour of administration rather simply allowing the victim to die (rather than one having a clear conscience )
IMHO.
VM

about the balls bit, men or mice

 

[MartinL]

MMM .............Ignorance is bliss!!!!!!

 

[sugarbush]

I am also a Registered Nurse and keep epinephrine on hand. In the states I am protected from litigation by "good sam laws". As a backup I carry 3 million in professional liability insurance.

The epi pens are mostly for use on others... Though you can develop a severe reaction to a bee sting even if you haven't in the past.

In my opinion anybody who works bees without an epinephrine pen on hand is a fool, unless your hives are on the roof of the hospital... A bee sting can change your life. An ambulance 20 minutes away can be the difference between a normal life and severe brain damage, with the only variable being whether you have an epi pen or not.

In North America bees kill more people per year than any other animal.

 

[AnotherNewBee]

If this Telegraph article is to be believed between about 1 and 3 people die from bee stings annually in the UK.

As you're in the US I assume you're including deaths caused by Africanised bees? If so, that's very different from the anaphylaxis being discussed in this topic.