Subcultureoftwo_small
Reputation: 1892

Anaphalaxis: Epipen vs. Epipen Jr.

Disclosure: I live in a very remote area.

I keep an Epipen on hand at our facility in case we have someone on the property going into anaphalaxis, and who made the idiot mistake of not bringing their own Epipen with them (people forget on a scarily frequent basis). It was a pain in the ass to get one, but we did. Luckily, we've never needed it.

We don't have kids here often, but it happens sometimes, and kids often have life-threatening allergies too. I do NOT have an Epipen Jr., and it's unlikely that I can get one.

If I have a kid collapsing in front of me from a peanut-venomed bee, am I better off getting the adult Epipen for them, or doing nothing and praying Lifeflight gets here in time? It seems like I'm choosing between suffocation and a heart attack.

I have a hard time getting a solid answer on this from doctors because it's already a shaky legal issue (damn right I'd give the Epipen to the parent to do). An EMT said he'd probably inject if it were him, but that was only one guy. Can I get a broader consensus? Is there a weight threshold below which an adult Epipen is deadly, period?

Answer this question or share it with a smart friend:

Avatar_default
Type your answer here…

2 Answers

  • Qlandav2ex_small
    Reputation: 4209

    If you feel that it is imperative to have such a device at your facility and you have already obtained one for just such emergencies, then it would be most appropriate to also pay for a consultation with an physician/pediatrician that specializes in emergency medicine to really have a better idea on when it is appropriate to use it and what parameters to follow concerning children.

    Medical devices approved for emergency use by non-medical people like the recent line of defibrillators are designed and prepared for use by persons without medical training. They come to market having been tested for use by lay people being able to follow the pictogram and limited instructions posted on them and being able to follow the programmed computer voice instructions.

    I am sure you are maintaining current first aid and CPR certifications and would expect that this additional training could be covered by the same mandate. Right now there are no physicians listed as contributors to this category and I would be reluctant to have you rely on the opinion of contributors here on the best use of such a device. I don't think you want to find yourself being deposed in legal proceedings explaining how you knew it was alright to use the device because of what was said by a Qlander.

    Most immediately I would suggest getting a good magnifying lens and sit down and meticulously read all of the product information sheet that came with the pen and if the info is not there you could call the manufacturer also. But for best practice get a consult with an emergency doctor.

    Share this answer with a friend:
  • Cateyes_small
    Reputation: 2173

    So, I have another (slightly tangetial) suggestion: have you considered taking a Wilderness First Aid (WFA) or Wilderness First Responder (WFR) course?

    I mention this because these courses are geared towards handling accidents in remote areas where help is hours or days away. The standard for regular first aid is to be able to provide urgent care for ten minutes -- the amount of time it will take an ambulance to get to your location and take over. If you are in a very remote area, you may find yourself in the position of caring for someone in critical condition for hours before you can get to help. This is an example course: http://www.remotemedical.com/wilderness-medicine-training/Wilderness-First-Responder-WFR

    As for the question at hand, though you are not legally licensed to give medication, you will typically be protected under good samaritan laws. (And consent is implied once a victim is unconscious.) You could certainly try to get an epipen jr., but given that these medications DO expire, it's more important that you keep the regular epipen on hand, as well as lots of benadryl. With any epinephrine shot, you only buy about 15 minutes before the anaphylactic reaction will start up again -- you MUST administer benadryl a the same time as the shot, and keep administering it until you get to the hospital.

    Again, taking a WFR or WFA course will review not only strategies for keeping people alive in remote areas, but discuss in detail how to negotiate thorny legal issues of providing care in emergency situations.

    Share this answer with a friend: