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EpiPen SubQ or IM?

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14 replies to this topic

#1 uglyEMT

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Posted 17 June 2011 - 01:55 PM

OK I know this seems like an obvious answer, to me at least, but it sparked a heated debate last night.

It was time for our liscense renewal class for Epi and a question came up on the test that asked the following:

When Administering EpiPen or EpiPen Jr. You Are Giving A(n)....
A) Subcutaneous Injection
B )Intravenous Injection
C) Intramuscular Injection
D) Intraosseous Infusion

naturally I chose C. A 1 to 1 1/2 inch needle is clearly an IM injection.

Now here is where the debate started, the Medic running the class said well according to the answer key it is A. I, being the inquisitive type :devilish: , asked why would it be SQ when clearly you are injecting into the thigh muscle. You are not putting it just below the skin between the dermus and muscle but into the muscle itself.

I was told that because Epi is supposed to be administered SQ that the answer is SQ. Again I said EpiPen is pushed into the thigh muscle thus the correct answer is IM.

Well you get the drift by now... this went on for a good 15 minutes. Was I totally off base with my thinking or was the instructors thinking flawed and just blindly following the answer key?

side note: Yes I know Medic administered epi can be done a number of ways, I am not talking about drawing your own injection and administering, I am strictly talking about EpiPen Auto Injectors here.

edited to change a stupid smiley where B should have been

Edited by UGLyEMT, 17 June 2011 - 02:28 PM.

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#2 ERDoc



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Posted 17 June 2011 - 02:42 PM

According to the prescribing info, if you look under "dosage and administration," it says it is administered "intramuscularly or subcutaneously into the anterolateral aspect of the thigh."

Think about it. In most people it will be IM, but there are many people that need a much longer needle to make it IM so it will end up SQ.
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#3 fiznat

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Posted 17 June 2011 - 05:17 PM

Where I work we used to give epi SQ but now we give it IM-- even when not using an autoinjector. The only answer that makes sense is IM.
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#4 HellsBells

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Posted 17 June 2011 - 06:02 PM

Your instructor is old school. IM is the standard for epi these days.

Your instructor is old school. IM is the standard for epi these days.
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#5 NYCEMS9115

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Posted 17 June 2011 - 10:32 PM

Regions vary... Some have taken out SQ Epi for IM Epi and others have kept SQ Epi... When NYC replaced SQ with IM Epi 2-3 years ago; Hudson Valley, NY still gave Epi SQ... It's up to the Physicians on the various Medical Advisory Committees... IM is a faster route than SQ...
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