Epipens, their use and possible dangers

[sugarbush]

In the US it is about 50 people per year from bee stings.

It does include AHB deaths as well, but they are confined to a fairly small area of the country and a small percent of the population is exposed to them. They are not really impacting the numbers all that much. Venom wise the stings are the same...

 

[AnotherNewBee]

If my maths (and the 3 deaths per annum according to the Telegraph) are right,

US population about 312M, UK about 62M

So, in the US about 0.16 deaths per M per annum.

In the UK about 0.04 deaths per M per annum.

Why do 4 times as many people die from bee stings in the US compared to the UK? Better health care in the UK? Faster transport to a hospital where successful treatment can be given? More allergy sufferers in the US?

 

[sugarbush]

Why do 4 times as many people die from bee stings in the US compared to the UK?

More bees. Our largest beekeeper has 80,000 hives. We have about 100 or so other commercial beekeepers who have 20,000 plus hives.

How many hives does the Uks largest operation have?

 

[victor meldrew]

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.

Africanised bees have venom no stronger than european bees Fact !
Anaphylaxis is a killer fact !
It only takes one sting to trigger it Fact!
Epipens buy time in emergencies despite adverse publicity by a few on here Fact !
VM

 

[AnotherNewBee]

Africanised bees have venom no stronger than european bees Fact !
Anaphylaxis is a killer fact !
It only takes one sting to trigger it Fact!
Epipens buy time in emergencies despite adverse publicity by a few on here Fact !
VM

Correct. Africanised bees are also more defensive, will attack in greater numbers than European honey bees and will follow much further. As a result it can be expected that Africanised bee attacks will result in more stings and, possibly, more deaths than European bee attacks.

I would still NOT use an epipen unless I KNOW BEYOND ALL DOUBT that the pen belongs to the person who has been stung OR I have been instructed by a qualified person that it should be used.

 

[AnotherNewBee]

How many hives does the Uks largest operation have?

No idea.

Perhaps the difference is due to population densities of bees and people?

An interesting bit of research for someone.

 

[sugarbush]

I would still NOT use an epipen unless I KNOW BEYOND ALL DOUBT that the pen belongs to the person who has been stung OR I have been instructed by a qualified person that it should be used.

Why not? The pens are one time use, single dose. There is no risk of O.D. unless you use more than 1 pen. If you are educated enough to recognize a reaction you can intervene early enough to instruct the person to administer it to them selves.... if they are unable to... the options are between you doing it or them dying. Personally when it comes down to that.... They can sue me right into the poor house if they like.... At least I am not going to live my life knowing somebody is dead who I could have saved.

 

[region2]

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?'

More likely 'does the casualty have an epipen?' - as a 1st Aider you administer drugs at the risk of being negligent - I am more qualified than a 1st Aider but I would never give any drugs without proper medical guidance. Good luck to anyone here who thinks differently.

R2

 

[region2]

Resuscitation Council advice -
http://www.resus.org.uk/pages/reaction.pdf

R2

 

[region2]

So my advice would be, by all means have a spare epipen kicking around, but do not administer it untl advised by a qualified person...

R2

 

[AnotherNewBee]

More likely 'does the casualty have an epipen?' - as a 1st Aider you administer drugs at the risk of being negligent - I am more qualified than a 1st Aider but I would never give any drugs without proper medical guidance. Good luck to anyone here who thinks differently.

R2

Resuscitation Council advice -
http://www.resus.org.uk/pages/reaction.pdf

R2

So my advice would be, by all means have a spare epipen kicking around, but do not administer it until advised by a qualified person...

R2

 

[victor meldrew]

Can anyone join in this mutual appreciation society ?

VM

 

[MartinL]

If my maths (and the 3 deaths per annum according to the Telegraph) are right,
Why do 4 times as many people die from bee stings in the US compared to the UK? Better health care in the UK? Faster transport to a hospital where successful treatment can be given? More allergy sufferers in the US?

Don't you know, everything is bigger in America! Including the ambulances and the traffic jams!

Besides its difficult to get your credit card out when you've gone into AS.

On the whole I think we in the UK are more emaciated than the average Yank too?

 

[victor meldrew]

4 times as many peeps in America
Larger rural area . (some hill billies haven't got running water yet )
%age wise ,about the same death ratio as here !
VM

 

[AnotherNewBee]

4 times as many peeps in America
Larger rural area . (some hill billies haven't got running water yet )
%age wise ,about the same death ratio as here !
VM

Population sizes already taken into account - hence 0.16 deaths per million per annum against 0.04 deaths per million per annum.

 

[alanf]

If my maths (and the 3 deaths per annum according to the Telegraph) are right,

US population about 312M, UK about 62M

So, in the US about 0.16 deaths per M per annum.

In the UK about 0.04 deaths per M per annum.

Why do 4 times as many people die from bee stings in the US compared to the UK? Better health care in the UK? Faster transport to a hospital where successful treatment can be given? More allergy sufferers in the US?

First thing to establish is are we comparing the same thing? Are both figures honeybee only?

Interesting calculation anyway. There are more bees in the US per human. The US ARS estimates 2.4 million colonies while the long-standing UK estimate is 250,000. That may be an out of date DEFRA number, but it's widely quoted: http://www.guardian.co.uk/environment/2010/may/02/food-fear-mystery-beehives-collapse - so around 10 colonies to 1 in the UK. It will be interesting to see if increasing hive numbers in the UK change the ratios.

My guess is that there might be a 'time to treatment' factor. Large areas of the US are relatively sparsely populated. You're a long way from a hospital or a doctor. You would have to look at distribution of deaths to show what the effect of distance is, maybe compare with other dispersed populations such as Australia or Canada.

 

[AnotherNewBee]

My guess is that there might be a 'time to treatment' factor. Large areas of the US are relatively sparsely populated. You're a long way from a hospital or a doctor. You would have to look at distribution of deaths to show what the effect of distance is, maybe compare with other dispersed populations such as Australia or Canada.

That would be my assumption. It might also explain the opinion that 'anybody who works bees without an epinephrine pen on hand is a fool'.

Different circumstances leading to different opinions.

If EpiPens were so important for UK beeks the BBKA would be selling them to registered beeks 'over the counter'. There's a reason they don't do that. In the UK they're prescription-only items. Unlike Aspirin they're not for use by just anyone.

Interesting that the BBKA advises:

'If the patient is already unconscious, an EpiPen should only be used if there is prior permission from the patient. This consent may be written or have been given verbally in front of reliable witnesses.'

That, I think, goes a little too far. I would use an unconscious casualty's own EpiPen without their prior consent. I'd also add 'If a bystander offers an EpiPen it should only be used under the advice of a suitably qualified health professional'.

 

[MartinL]

If EpiPens were so important for UK beeks the BBKA would be selling them to registered beeks 'over the counter'. There's a reason they don't do that. In the UK they're prescription-only items. Unlike Aspirin they're not for use by just anyone..

NEGLIGENT / Unqualified use of an epipen, (no matter how well intended) is more likely to lead to hospitalization or death than a BEE Sting.

That's why Pharmacists and Doctors have to study in a little more depth than watching the TV dramas, "ER, Holby City" e.t.c!

We should all be deferential to those who have taken the time to study for proper qualifications, and not let our egos be fooled by the allurement of the melodramatic TV script writer's mythical worlds.

 

[The Cumbrian]

NEGLIGENT / Unqualified use of an epipen, (no matter how well intended) is more likely to lead to hospitalization or death than a BEE Sting.

That's why Pharmacists and Doctors have to study in a little more depth than watching the TV dramas, "ER, Holby City" e.t.c!

We should all be deferential to those who have taken the time to study for proper qualifications, and not let our egos be fooled by the allurement of the melodramatic TV script writer's mythical worlds.

 

[victor meldrew]

This is all academic of course .
Circumstances will dictate actions on the day !!
None of the dissenters know quite what they would do when presented with a situation that requires positive action . Truly they don't
VM