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post #1 of (permalink) Old 09-18-2007, 03:14 PM Thread Starter
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Default EpiPens

With the recent discussion of EpiPens, on a trip report thread, I thought I'd post a few things to be aware of. Who knows maybe one day you might need to use one or give one to someone.

Epinephrine is a chemical which narrows blood vessels and opens airways in the lungs.

Do not inject epinephrine into a vein or the buttocks. Inject it only into the fleshy outer portion of the thigh.

If you experience any of the following serious side effects, seek emergency medical attention:

* very high blood pressure (severe headache, blurred vision, or flushed skin); or
* greatly increased difficulty in breathing.


Other, less serious side effects may be more likely to occur and may include:

* fast or irregular heat beats;
* sweating;
* nausea and vomiting;
* pale skin;
* dizziness;
* weakness or muscle tremors;
* headache; and
* apprehension, nervousness, and anxiety.


Best thing to do is seek a doctors advice as to whether you should use one or not.






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post #2 of (permalink) Old 09-18-2007, 03:43 PM
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Good to know!

I would like to add that IF you suspect that you are allergic to insect stings, there IS a blood test that can be taken to detect the anti-bodies. For me, it was Yellow Jackets, White-faced Hornets and Yellow Hornets.
I will be starting the de-sensitizing program (3 years) in December.

Depending on your doctor or your case, this test may be free, or you may have to pay for it...don't know how much it costs, but it could bring peace of mind!
Also, having an allergy does not necessarily mean your children will inherit it, but they could...another reason to have some sort of "medication" on hand when you hike!
Extended medical WILL pay for Epipen, mine cost me $24...small price to pay really, when you consider what could happen if you DON'T have one!

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post #3 of (permalink) Old 09-18-2007, 03:49 PM
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Also:

Accidental injection of epinephrine into the hands or feet may result in a loss of blood flow to the affected area. If this occurs, go immediately to the nearest emergency room for treatment.

Do not remove the safety cap until you are ready to inject this medication. Never put your fingers over the black tip when removing the safety cap or after the safety cap has been removed.



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post #4 of (permalink) Old 09-18-2007, 04:07 PM
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Shaggy: great topic.

Quote:
quote:Originally posted by TheShadow

I would like to add that IF you suspect that you are allergic to insect stings, there IS a blood test that can be taken to detect the anti-bodies. For me, it was Yellow Jackets, White-faced Hornets and Yellow Hornets.
Absolutely agree. If you're unsure, it's worth getting the tests done before heading out into the bush. A little foresight could save your life.

It makes me wonder what the mortality rates of anaphylaxis and asthma attacks are among hikers compared to, oh, let's say, bear attacks. It seems to me that they are a far greater danger.
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post #5 of (permalink) Old 09-18-2007, 04:44 PM
 
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As soon as I get a sting, I typically munch on a Benadryl or 2.
Only had injections once (in the hospital)[xx(]

I make up my own "Ana-kit" (re-using the old Ana-kit box) - as Bayer has discontinued them.
The epinephrine vials are ~$2.50 each, but you DO have to snap off the top & fill the syringe yourself - not something many people are willing to do in an emergency.
A bag of 1cc insulin syringes is ~$5.00
The Benedryl is the most expensive part.
The epinephrine has a one to 2 year shelf life.

When you give the injection, it is supposed to be subcutaneous or intramuscular. ie: the meaty part of your shoulder, where you normally get influenza shots.
-after the needle insertion, the plunger is often drawn back slightly to see if any blood is indicated in the syringe.
If there's a drop of dark blood showing, then the needle has obviously hit a vein.(Pink/clear is OK).

I'll hop off the soapbox now...

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post #6 of (permalink) Old 09-18-2007, 04:55 PM
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Thanks!
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post #7 of (permalink) Old 09-18-2007, 07:09 PM
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Don't use one unless you really really need too. Especially if this thread is your first intro to epi. If you are not trained to know when to use it then find that out, preferrably through an advanced wilderness course.

You know what I just realized....no one has mentioned anything about correct dosages or contraindications or when it should be used. You can really f some one up if you don't know this.
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post #8 of (permalink) Old 09-18-2007, 07:32 PM
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Just in case there is any confusion, epinephrine IS adrenaline. Injecting a hormone into someone seems like pretty serious business. I would think proper training is essential.
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post #9 of (permalink) Old 09-18-2007, 09:29 PM
 
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There ARE instructions and contraindications that come with every drug sold, even OTC.
Yet people still take Tylenol (acetaminophen) for a hangover!

"You can't fix stupid!"
Ron White
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post #10 of (permalink) Old 09-19-2007, 09:42 AM
 
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"You know what I just realized....no one has mentioned anything about correct dosages or contraindications or when it should be used. You can really f some one up if you don't know this."


The dose for Epi (at least in Sask.) is 0.5mg and can be reapeated as needed in 5 - 10 mins.
Most of the contraindications can't be checked by the average person, but if the pt. is tachycardic (heart rate over 100bpm) I would think twice about it!
Having high blood pressure doesn't always show with the headache, blurred vision etc. so unless you have a B/P cuff you may never know...thats why it's called the silent killer...most people don't even know they have it.
Epi will increase your B/P and heart rate, it will also make you photophobic, due to pupillary dilation (epi acts on the sympathetic nervous system - "fight or flight") so yeah you will start to breath faster and feel anxious, dry mouth, diaphoresis etc.
Giving IM means it will get into your system faster but the Sub-Q route means it wiil have a slightly longer effect.
My advice is know when to give/take it...take a course, talk to your Dr. and even after that, if in doubt don't give it...having said that, do the benefits outweigh the risk??...What would yo do if you best bud was looking really bad and you were 4 hours from any kind of help?...if you leave him/her to get help they could very well die, if you give the epi you may save their life...then again you may not!
I don't mean to be a downer but the harsh reality is that the human body, while a wonderful piece of engineering, is not a machine and the thing that worked for it yesterday may not work today!
So you have to make the decision...I know what I would do, but then I'm a Paramedic
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post #11 of (permalink) Old 09-19-2007, 01:09 PM
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Quote:
quote:Originally posted by hike_in_van

Thanks!
Totally agree... this is a topic of interest for me and I thank all that are contributing their knowledge to it.
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post #12 of (permalink) Old 09-19-2007, 01:13 PM
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Quote:
quote:Originally posted by Chrimbler

I don't mean to be a downer but the harsh reality is that the human body, while a wonderful piece of engineering, is not a machine and the thing that worked for it yesterday may not work today!
So you have to make the decision...I know what I would do, but then I'm a Paramedic
Which is why I am also packing the homeopathic cure that worked for me, and I would suggest/recommend that anybody with a sensitivity (or allergy) do the same. Talk to someone who is well versed in this practice and stock up with a few items; they're no more expensive than traditional medicines. The upside of homeopathic cures is that they can be taken WITH conventional medicines - if the latter is needed as a last resort.

I'm no expert in Homeopathy, I just know what worked for me and how well it did! This will be a part of my kit from now on!


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post #13 of (permalink) Old 09-19-2007, 02:22 PM
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Quote:
quote:The dose for Epi (at least in Sask.) is 0.5mg and can be reapeated as needed in 5 - 10 mins
The epi auto injectors are .3 mg for adult and .15 for children. Are you an ALS provider? You guys draw your own...you don't use the auto injectors do you? You guys can also play with vasodilators and blocking agents to counteract the rise in b.p. if it ends up being too much.
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post #14 of (permalink) Old 09-19-2007, 05:54 PM
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Quote:
quote:Originally posted by TheShadow


Which is why I am also packing the homeopathic cure that worked for me,
where did you buy the Apis Mellifica ? locally?
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post #15 of (permalink) Old 09-19-2007, 06:15 PM
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Goatboy, nice thinking on saving your old ana-kit box. I wish I had done that! Although with my fair pharmacare and student medical I can afford the epi-pens now, there was a time when I couldn't!

However, there are not too many people around me who would be able to give me the epi from the vial anyway, so the epi-pen makes it more reliable.

As for dosages and stuff, don't you need a prescription for epinephrine anyway? When I used to carry a vial and syringes, the dr and pharmacist would always go over it again with me. I didn't think you could get it without.
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