Epi in NJ

[CBEMT]

Apparently, Mr. Afib hasn't been around very long, or he'd know that it is NOT always easy to tell anaphylaxis from an AMI. In fact, about half the time, it's very, very difficult. With no 12-lead and 120 hours of advanced first aid training, you have no chance. If you give that epi to an AMI, you're going to kill him. Plain and simple. Yeah, that's a "good thing." Rolling Eyes

Wow. Better tell everybody with an epi pen that they need to give themselves a 12-lead before they self-administer. They might be having an MI. :roll:

I know, personally, when I find somebody wheezing, sometimes grey, with a head blown up like a balloon, and looking like they're going to die, the first thing I think is "Shit, I better do a 12-lead first."

[akroeze]

Sorry Dust, gonna have to side with them here. There is no way you can be suggesting that it is necessary to do a XII lead before administering epi for anaphylaxis is there?

[angelbaby1414]

Noone is saying that 1 epipen is going to cure a severe allergic reaction, but if it buys you 5 or 10 minutes until the medics get there, I'm all for it. I am also speaking as someone who has idiopathic episodes of anaphyalaxis, and may have to wait 10-15 minutes for ALS, I am VERY GRATEFUL for my epipen.

[Asysin2leads]

Some points here seem to be being missed. First off, I'm not sure if the debate is for BLS to give ANYBODY off the truck epi or to only give it to people who are prescribed an epipen but don't seem to have it on them.

These are two completely different cases. When someone is prescribed an epipen, it is after a qualified physician has evaluated them, consdidered their medical history, and written a prescription. People who have epi-pens prescribed don't need to do 12 leads on themselves because when their prescription was written, a physican either had done one already or did not deem it necessary. When ALS gives off the truck epi to someone who has no previous diagnosis of anaphylaxis, it is because they are acting in lieu of the physician, a major difference between ALS and BLS. This is where doing a 12 lead comes in, to form the proper diagnosis.

Bottom line is if people dying from anaphylaxis is that big a problem in New Jersey they can feel free to stop screwing up their EMS system so badly. Either pay for timely provision of ALS services, or risk people croaking. Simple choices.

[MeekoBB]

So far since epi came on trucks, a doc reported at a recent lecture i attended, that he had like 5 pts come in after injected with epi, 3 by bls who injected because of "possible" allergy to something, and 2 emts who accidently stuck them selves.

ohyea, epi on trucks in great! :roll: :roll: :roll: :roll: :roll: :roll: :roll:

my truck hasn't used it yet, but its great because we have 3 members who have personal epipens for serious allergies (all latex) and if we cant get to their access, we know we have on the truck.

[WestSideBorderPatrol]

Here in Maryland we carry EpiPens on the ambulance. We have both adult (.3mg) and pediatric (.15mg) auto-injectors.

As an EMT-B we are allowed to administer an EpiPen to our patient only if it is prescribed to them. We also have to consult with med control before administering it. However in the event of severe allergic reaction or sever asthma, we don't have to consult before administering.

Although i have never had the need to give a patient an EpiPen, we have had calls where a "caring friend" tried to administer the EpiPen to a patient when they ended up sticking themselves and we had to go and use one of our doses. :roll:

[akroeze]

Although i have never had the need to give a patient an EpiPen, we have had calls where a "caring friend" tried to administer the EpiPen to a patient when they ended up sticking themselves and we had to go and use one of our doses. :roll:

Aren't you contradicting yourself there? o.O

[WestSideBorderPatrol]

Aren't you contradicting yourself there? o.O

I was using the word, "we" in the sense of it meaning "one of our crews"

Sorry for the confusion.

[Dustdevil]

Wow. Better tell everybody with an epi pen that they need to give themselves a 12-lead before they self-administer. They might be having an MI. :roll:

As Asys and EvilEmpress point out, your point is not relevant to that which I was making. The circumstances under which a patient self-administers are not the same as those which an EMT-B uses as an excuse to play paramedic. There is no diagnostic process required for the former. There is for the latter. And I've seen medics fark it up, so I know 2 week EMT-Bs will fark it up.

[MeekoBB]

As Asys and EvilEmpress point out...

Whoa, let me get this right...did i actually say something right?? :shock:

Personally, my opinion, as minute it may be, I see epipen administering as this in my particular area---- am i comfortable with my patient's airway/breathing until arrival of ALS or arrival at the ED?? I have 3+ hospitals within 10min to my city and few times, and 97% ALS is either on scene prior to my arrival or Very close after I get to the patient. My assessment of the airway runs faintly along the "choking" assessment. Are they coughing with sounds? Speaking? Their is still air moving, although not adequately...does it warrent epi? Not always. Where's my ETA for ALS? 5 min? Let's move, and possibly rendezvous, but not waiting and I'm hesitate on administering such a powerful drug. If I feel the patient will not hold their own prior to ALS or ED, then I would push it, but not before.

On that end...it ALL always comes back to your assessment. Are you sure it's an allergy? Anaphylaxis is serious, but not all SOB is that...There is asthma, anxiety, etc which all can also mimic symptoms of one another in some presentations. Ie, pt with hx of asthma, with SOB...is it automatically asthma? Add in from that nagging SAMPLE - pt had say...shrimp for the first time tonight...is it asthma or allergy? Wait...where did our empathetic side go? Coworker only said pt just returned to her desk after a meeting with the boss...hmmm...

It's all proper assessment and if you don't have a systematic approach, and in some cases you may miss something. Patient Assessment should be reenforced in every recert stronger.

ETA: I'm speaking/thinking from a BLS POV.