Michael Posted June 24, 2006 Share Posted June 24, 2006 He compalins of a mild scratching in his throat and a little sob. = He is accompanied by his annoying young son? Link to comment Share on other sites More sharing options...
medic53226 Posted June 24, 2006 Share Posted June 24, 2006 AZCEP, In our system our max is .5 mg of 1/1000 and we had given a pt with a allergic reation to a wasp sting and when he came out of the reation he had a terrible HA and our Medical Director said that we should start off with .15 dose and increase as needed to the max, and since the pt is mild to moderate I felt that this would be a better dose then the .3 mg that is the usual dose in most systems. Link to comment Share on other sites More sharing options...
AZCEP Posted June 24, 2006 Share Posted June 24, 2006 It is reasonable, but unusual. If the patient needs Epi to attenuate the anaphylactic response, doesn't that usually mean that they need it to work more quickly? I'm just having a tough time wrapping my brain around the logic, but I don't make the decisions. Next question, how long do you wait to give the follow up dose? Link to comment Share on other sites More sharing options...
medic53226 Posted June 25, 2006 Share Posted June 25, 2006 I agree with what you are saying, but this is what he advised and change the protocol so that we could do this, if the pt didn't respond to the intial dose we were to give another .15 mg to the max of .5mg of the 1/1000. I haven't had a pt since that was needing to use this protocol, but I though that is was interestiing. Link to comment Share on other sites More sharing options...
medic53226 Posted June 25, 2006 Share Posted June 25, 2006 Also to answer question of how long he said 1- 3 mins they should respond, but it depends on the pt, because you know as well as me that everyone reacts to a med different than the other. Link to comment Share on other sites More sharing options...
AZCEP Posted June 25, 2006 Share Posted June 25, 2006 I've used 0.1 mg of 1:10 000 before, but this is the first I've heard of smaller SQ/IM doses. Wrong or right, I guess it makes good sense if the wait time before the next dose is fairly short. Seems a bit restrictive from a treatment guideline perspective, but I don't want to bash someone else's situation. Too many unknowns for me to do that. Just look at the "glucagon discussion", and the ugly direction that took, for example. Link to comment Share on other sites More sharing options...
medic53226 Posted June 26, 2006 Share Posted June 26, 2006 I agree with what you are saying and understand your hestation, it would have never been talked about and we would have continued with the .3 mg, if the pt hadn't be of political importance in our community, but I have never had to use the the epi 1/10000, because it is in our severe allergic reation protocol and we use the 1/1000 SQ unless they are severe or develop into severe. Link to comment Share on other sites More sharing options...
emt322632 Posted June 26, 2006 Share Posted June 26, 2006 My tx would have been along the same lines as all the others. O2, IV, monitor, IV benadryl 25mg, we don't carry solumedrol up here (yet, it's in the works so I've heard) keep the epi handy just in case and transport to the hospital. Any new medications this guy is on? No itching or symptoms before eating the offending cuisine? We already established the Benadryl wasn't working...no severe airway compromise so in our region we hold on the Epi unless airway compromise is noted... How's he doin otherwise? any new symptoms? tingling in his throat gotten worse? any worsening of the SOB? Link to comment Share on other sites More sharing options...
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