Epi Pens

[Adi.]

......the pharmacist made a point of demonstrating to my husband with an out of date one, the point isn't accessible once the thumb pressure is released. It retracts.

cheers,
M

I don't know what product this was but by saying thumb pressure suggests it was not an Epipen. The old style Epipens, which are still available in the UK, once fired left the needle exposed.

 

[Toddy]

From the other side of things; it's damned scary when my own body starts reacting and there's nothing I can do to stop it
By the time I feel my heart fluttering like a bird trapped in my chest I reckon I need help; now! The bite on my throat that threatened my breathing though.....that was most unpleasant

I'm very glad, and grateful, that people take the time and trouble to suss out how to, why to, and when to, help, when either I can't, or someone else can't help themselves, either.

Mine is simply labelled, in the manufacturer's box...EpiPen, Auto-Injector 0.3mg, Adrenaline (Epinephrine) Solution for injection for intramuscular use. Delivers one sinle dose (0.3ml) of 0.3mg Adrenaline (Epinephrine). Injects medicine for Allergic Emergencies (Anaphylaxis)
This is my third one so it's not a new-new development, iimmc.

I live near water, lots of water, clegs are commonplace at some times of year. I do get bitten, I do react, but the antihistamines have so far been incredibly effective.

Don't underestimate a simple across the counter solution. I do find the effect is better with anti inflammatory (ibuprofen, again commonly available) too though.
I wouldn't risk foreign travel or camp without the EpiPen. My family and friends know I *always* have anti histamines with me, (spy capsule on my keyring, among other places) and those closest to me have all been shown the pen and given the instructions to read.
This wasn't just for my sake, but it helped reassure them too; that they knew what to do should there be an issue I couldn't deal with. Not fair to leave them worrying.

It's a bit of bu88er, but it's life; sod's law and all that.

The *really* scary bit is how many children are allergic to so many things nowadays not just someone like me who's been bitten so often that my body sees it coming now and over reacts.

cheers,
M

 

[Toddy]

I haven't used it Adi; the pharmacist said that without pressure it would be into the leg and out again and safely inside the pen and it can't be reused.
The instructions say to hold it against the outer thigh for ten seconds.
It comes in a rather robust plastic tube that we're supposed to put the pen back into, put the bung back on, and hand the whole thing into the chemist or surgery when possible.

cheers,
M

 

[Rob]

The kids thing is frightening indeed. As is having your body doing something crazy.

From the work that I do at schools, an epipen bumbag used to be something that you could occasionally see - nowadays, it does not surprise me to see half a dozen kids out of a group of 30-40, plus another one on a TA or other member of staff - containing spares.

I often wonder if it is something more of a "just in case" thing with some kids, who have bad allergies that may not have been prescribed for a few years ago but now carry one "just in case the next time it is worse".

For those who do have them prescribed, it is good to know that you can log your pen with the epipen website and they will send you a reminder when it is time to get a new one.

 

[rik_uk3]

Yes. I’ve had training to recognise an anaphylactic reaction, and to use an EpiPen.

There’s a reason why it’s called an “expedition” medical course. Some of us don’t restrict our travels to a 5-room tent with built in Jacuzzi on a Caravan club approved site :

At £40 a pop with a 6 month shelf life I have no intention of carrying one myself in the UK (unless a doctor prescribes that I need one).

Still it's useful knowing how to use one on a casualty who is unable to use their own

Good to know. Lets keep things simple, doing a course is one thing, doing it for real is a totally different world. I was involved in dozens of cardiac arrests in Nursing and no matter how many times the shout went out, you ring goes tight and you have to make yourself think. Simple as simple can be is the order of the day in first aid situations.

PS I only have four bedrooms in the family tent

PPS got a porta potti in the summer sales

 

[bikething]

Good to know. Lets keep things simple, doing a course is one thing, doing it for real is a totally different world.

Hopefully I'll never have to do it for real... but if i do, I think it's better to do the course, then do it for real
.. rather than the other way round

I was involved in dozens of cardiac arrests in Nursing and no matter how many times the shout went out, you ring goes tight and you have to make yourself think. Simple as simple can be is the order of the day in first aid situations.

In the absence of a plentiful supply of real casualties (I'd like to keep it that way ) I'll have to make do with the occasional course to get my practice

PS I only have four bedrooms in the family tent

that's more than I've got in the house! LOL

PPS got a porta potti in the summer sales

I ain't lugging one o' them through the jungle

 

[santaman2000]

If you are in a position to lead an expedition or to do medical cover for one then I would hope you would know the law. If you don't you have no right being in a position of responsibility.

There is no country that would stop a trained expedition medic from treating a member of the expedition in country. Start treating the local population you might open yourself up to problems...

It is however wise to check what drugs you wish to take with you are legal in that country as not all drugs available in the UK are legal in other countries. That also goes for drugs obtained in other countries that you may decide to bring back to the UK. Some drugs available in the states are illegal here, including some over the counter products...

On your 1st point; I agree. That was pretty much the same point I was making.

On your 2nd point; I'm not so sure. Here it's regulated by the individual states and I know of no state that has a separate standard of care for foreigners. However I suppose expeds here might be limited to less remote sites where the issue wouldn't come up.

On the 3rd point; again I agree, but I don't believe it's going to be an issue for Epi.

 

[Adi.]

I haven't used it Adi; the pharmacist said that without pressure it would be into the leg and out again and safely inside the pen and it can't be reused.
The instructions say to hold it against the outer thigh for ten seconds.
It comes in a rather robust plastic tube that we're supposed to put the pen back into, put the bung back on, and hand the whole thing into the chemist or surgery when possible.

cheers,
M

I would suggest when this one runs out you get yourself an orange and you use it on the orange just so you know what it feels like to use one. Like this http://www.youtube.com/watch?v=9GYruyl9_j8

 

[kiltedpict]

I remember as a student nurse practicing on an orange! Brings back memories

 

[Pict]

As someone who carries an epi pen (cleg bites) and has a permanent prescription so that when one dates out I have a fresh one to hand, I can categorically state that the only ones I've ever seen are 'Auto-Injector' and leave no exposed sharp end, and that the use by date has always been at least a year.
My present prescription is dated 10/03/11 and the exp date on the pen itself is 04-2012

The thought of managing to stay cool headed enough to stab myself with this one is bad enough, the thought that I would have to manage the co-ordination to effectively fill a syringe too, is not funny, especially since the likely symptoms include, "shortness of breath, nausea, vomiting, stomach cramps and insome cases, loss of consciousness".

If it's of any help, my Doctors tell me that should I present at hospital with anaphylaxis then the epi pen is the last thing they would use. First response is anti histamine, not adrenaline. The very same anti histamines that are available in packs of seven in every poundstore in the land.

Hoping no one (me included) ever needs the pen, but it's rather reassuring (to me *and* to my family and friends) that it's available.

cheers,
Toddy

I have had to Epi myself and it is a terrifying experience. I have had two severe reactions and to this day we have no idea what caused them. The second one I used the Epi as we live about 40 minutes form the nearest hospital and ambulance service here is a joke. Staying cool enough to stab yourself is the hard part. My reaction started when I was sound asleep of all things. I suddenly woke up with that doom feeling and knew right away what was happening. I had the presence of mind to get my wedding ring off as the first time I swelled up so bad it was killing me. It looked like the metal staple between two sausages.

I made it downstairs and the world started to fade really fast. I sat down before I fell down and stabbed myself in the side of the leg. The effect is amazing. It's not like, "Wow everything is OK!" It's more like, "Wow, I'm still here!" (and I still really feel like crap) They do buy you some time but aren't really a treatment. If you do have to use one expect a really sore leg the day after. Maybe I was just really keyed up and aggressive with it but its like getting punched in the leg with a narrow baton tipped with a needle. I sincerely hope you never need one. Mac

I would carry one still but my spare is now out of date and I can't get them here in Brazil.

 

[Toddy]

Thanks Adi, I might well try that

Pict, I really hope neither of us have to use the pens, but thank you for adding your experiences; I admit I have wondered just what it might feel like to both need and have administered the epipen.

Have you looked at the research results from the American military testing of 'out of date' pharmaceuticals ?
Makes for very interesting reading. Apart from nitroglycerine heart medicines, insulin, liquid anti biotics and certain water purification tablets, virtually all pharmaceuticals are thoroughly effective beyond their supposed 'expiry' dates. Apparantly dispensing chemists routinely put the date at a year from date they re-packaged or sold the drugs, regardless of the manufacturer's own expiry dates.
The research has literally saved the American military millions of dollars with no loss of efficacy of the medicines.

cheers,
Toddy

 

[santaman2000]

True Toddy but as epinephrine and insulin are both hormones, I suspect they might expire on a similar schedule to one another. Just a guess though. At any rate since epinephrine is used for emergencies would you really want to depend on it? At at the same time, if all you had was an expired one, what are your choices?

 

[Toddy]

Much my point tbh, especially if they aren't available in Brazil. Tbh if experience showed my reaction to be so dire I think I'd try to source and import if necessary.

Storage can be critical with them though; high temperatures in particular seem to be very detrimental to the contents of the pen.

cheers,
M

 

[santaman2000]

Yeah, temperature is the problem for my diabetic meds also. Not on insulin but I was injecting Byetta for years until last week when I was switched to Victoza (also injected) Supposedly no need to refrigerate but the listed temp range (40ish up to 86F) isn't realistic in the outdoors here in Summer. An insulated lunch bag with a cold pack works for a day trip but after that I'm S.O.L.

 

[rik_uk3]

"Have you looked at the research results from the American military testing of 'out of date' pharmaceuticals ?"

Interesting point. There were thousands of morphine ampoules recovered from a WW2 ship wreck and the drug was still perfect, some of the morphine issued to troops in the Falklands was packed in WW2 as well. I cleared out an old first aid kit last year, one I'd taken to the 2006 bushmoot and there was a Ventolin inhaler dated 2007 and my lad used it when he ran out/lost his one weekend...worked and did the job. I'm not advocating relying on out of date drugs but it makes you think how many are wasted. Don't know if it still happens but the NHS used to send out of date antibiotics to third world countries.

 

[TeeDee]

Have you looked at the research results from the American military testing of 'out of date' pharmaceuticals ?
Makes for very interesting reading. Apart from nitroglycerine heart medicines, insulin, liquid anti biotics and certain water purification tablets, virtually all pharmaceuticals are thoroughly effective beyond their supposed 'expiry' dates. Apparantly dispensing chemists routinely put the date at a year from date they re-packaged or sold the drugs, regardless of the manufacturer's own expiry dates.
The research has literally saved the American military millions of dollars with no loss of efficacy of the medicines.

cheers,
Toddy

Can anyone provide a link for this please? I've heard of the report but I think its been pulled down from most websites due to pharma-Industrial pressure. I 'd be interested in reading it if anyone can stick an active link up.

thanks

 

[Pict]

I do need to get a new pair of Epi-pens. I still have the expired one. As noted they are not cheap, I do need a prescription, and they are only available to me in the US. So for me all the planets have to align. Most of the time I go back the US it is for six months to a year and I keep telling myself that I'll get a new pair of epi's at the end of my stay so they won't expire so soon after I get back home.

 

[dwardo]

"Have you looked at the research results from the American military testing of 'out of date' pharmaceuticals ?"

Interesting point. There were thousands of morphine ampoules recovered from a WW2 ship wreck and the drug was still perfect, some of the morphine issued to troops in the Falklands was packed in WW2 as well. I cleared out an old first aid kit last year, one I'd taken to the 2006 bushmoot and there was a Ventolin inhaler dated 2007 and my lad used it when he ran out/lost his one weekend...worked and did the job. I'm not advocating relying on out of date drugs but it makes you think how many are wasted. Don't know if it still happens but the NHS used to send out of date antibiotics to third world countries.

Just been to the docs to have my inhalers renewed, both were 18 months out of date and if it wasnt for the missus spotting the date i would still be using them

 

[Adi.]

On your 2nd point; I'm not so sure. Here it's regulated by the individual states and I know of no state that has a separate standard of care for foreigners. However I suppose expeds here might be limited to less remote sites where the issue wouldn't come up.

The definition of expedition medicine is more than 4 hours from professional medical care.

 

[santaman2000]

The definition of expedition medicine is more than 4 hours from professional medical care.

Difficult to imagine. I can certainly imagine many places (even here) that are more than 4 hours from professional medical care BUT...If a group were truly called an "expedition" then one would think that a foray to such a place would include a properly equipped medical "professional."