Posted: 3/19/2012 12:14:58 PM EDT
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Just had this land in my inbox and thought I would pass it along as I had not heard of this technique before today. This shows how to obtain 2-3 additional doses from a "used" Epi-Pen
http://www.youtube.com/watch?v=Ug6FcA0d-30 The instructional portion of the video doesnt begin until 3:15 |
| I talked to my doctor about the epiepin and he told me that they were not very heat stable and would go bad quickly if left in a hot car or toolbox. He then suggested that a better alternative was to use liquid benadril and not worry about the dose just to drink it and head to his office or the Hosp. |
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You need to be able to differntiate between allergic reactions and true anaphylaxis.
Anaphylaxis is usually a sudden/rapid on set of dyspnea and hypotension. Always consider life over limb, but with that being said, epinepherine is not benign. It can induce cardiac dysrhythmias, and MII's (heart attacks) especially those with pre existing heart conditions, or older individuals. Make sure when it is administered it is needed. Always follow up a epi injection with a trip to the ER. |
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Quoted:
I talked to my doctor about the epiepin and he told me that they were not very heat stable and would go bad quickly if left in a hot car or toolbox. He then suggested that a better alternative was to use liquid benadril and not worry about the dose just to drink it and head to his office or the Hosp. A real MD told you this? Epi isn't very stable- it's the drug, not the pen. But there no compairson between IM epi and oral benedryl. It's better then nothing, and while IV/IM benedryl is commonly used, there are no studes demonstrating it's effectiveness. When you need Epi really bad, you may not even be able to swallow. And if you need epi, you dial 911, not drive to the doctors office, unless they are almost next door. I wouldn't even head to the hospital without dialing 911 first. There used to be a product called Anakit, it was mostly carried by first responders or trained laymen, it was 1 cc of epi in such a way that the first push bled the air. you could rotate the plunger 90 degrees and administer 0.3cc, and rotate a second time and administer a second 0.3cc, or if you were careful, you could get 3 0.3cc doses. You could also administer peadatric doses. The problem was MDs tended to perscribe the epi pie which was far easer for a child or bystander to use, and actual ambulances and EMS vehicles carried viasl, ampules, or sytinges of epi, and the Anakits were mostly used by wilderness adventurers, in EMTs jump kits, in wildfire crews bags, etc. Not much of a market. My doctor had never seen one before writing me the perscription, but promply ordered 2 for himself. Also the package was rugged. I used to keep one in a GI dressing pouch on my repelling harness after an expected encounter with hundreds of wasps while on a rope. Now with the price of an Epi pen, I don't bother. When epi goes bad, it becomes amber colored. I was allways able to reach the expiration date by keep the anakit in my tool box (white) with a gel pack (which would moderate summer highs.) It is the general belief in EMS that epi does not break down into particularly harmful byproducts, and "colored" solution can be used if there are no other options. |
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I get my doc to prescribe Twinject pens because I really like having a second dose immediately available. Then I tape a pair of Benadryl capsules to the pen. Take the Benadryl as soon as you know you've been stung/eaten something you're allergic to/been exposed to allergen. Shoot the epi if you need it, but make sure you're on the way to the hospital (in an ambulance or being driven by a friend or family member) as soon as it's obvious you're headed toward an anaphylactic reaction. Have the second dose out and ready as soon as the first has been injected. Epi is short-lasting. I wouldn't mess with the method shown in that video unless I absolutely had to. I buy Twinjects so I don't have to mess with cutting open Epipens under stress. I really preferred the old Anakit for its simplicity, but they've been off the market a long time. |
| I have a question about them. How long and sharp is the needle? A friend of mine said a couple of years ago his neighbor got bitten or stung, I don't remember specifically, and called my friend to drive him to the hospital. When they first got in the truck the guy was fumbling with the pen, panicking I guess, and instead of jabbing the needle in his thigh he had the pen upside down jabbed the needle through his thumb up through the thumbnail. Is this possible? |
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Quoted:
... There used to be a product called Anakit, it was mostly carried by first responders or trained laymen, it was 1 cc of epi in such a way that the first push bled the air. you could rotate the plunger 90 degrees and administer 0.3cc, and rotate a second time and administer a second 0.3cc, or if you were careful, you could get 3 0.3cc doses. You could also administer peadatric doses. The problem was MDs tended to perscribe the epi pie which was far easer for a child or bystander to use, and actual ambulances and EMS vehicles carried viasl, ampules, or sytinges of epi, and the Anakits were mostly used by wilderness adventurers, in EMTs jump kits, in wildfire crews bags, etc. Not much of a market. My doctor had never seen one before writing me the perscription, but promply ordered 2 for himself. ... Yep. I started using them when I was working as a wilderness first responder/backcountry trip leader and was responsible for carrying an Anakit. I was sad to see them go. |
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Quoted:
I have a question about them. How long and sharp is the needle? A friend of mine said a couple of years ago his neighbor got bitten or stung, I don't remember specifically, and called my friend to drive him to the hospital. When they first got in the truck the guy was fumbling with the pen, panicking I guess, and instead of jabbing the needle in his thigh he had the pen upside down jabbed the needle through his thumb up through the thumbnail. Is this possible? Yeah, probably. The needle on an Epipen is about an inch long (I'm guesstimating here.) If you watch the OP's video there's a demonstration of jabbing an Epipen through a piece of cardboard. When the needle is withdrawn you can see its length. (This is on an older style that didn't have a spring-loaded guard on the needle.) The needle length is fine for shooting into a thigh, shoulder, or butt. Intra-thumbical injection is contraindicated. 
ETA: These guys say the Epipen has a ~0.56" needle as of 2005. My tape-measure says that could protrude through my thumbnail if I shot straight through the thinnest part of my thumb. |
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I'd think any male with small to average hands could go straight to their thumb nail. I'm more familair with the atropene and 2-PAM autoinjectors and they would absolutely do it.
I guessing shooting 0.3 ml of epi into your thumb is very bad. One it's 0.3ml of stuff, in a thumb about three times that size and two epi is a vasiconstrictor, so its going to to reduce bloodflow needed to disperse it, which could well make frostbite possable. I can see an urban legand where they guy get stung by a ant on his leg and end up getting his thumb amputated. I suspose you could carry alcohol to counter act the epi, but that might explain why he had the pen upside down to start with. I guess you could do this with a vallium autoinjector and not care:-) Seriously, you are supposed to hold the autoinjector like a 4D maglite when using. Also I took one apart one time- wear safety glasses- there is a serious spring in there that I saw for a split second as it passed by. I don't remember the details, I but didn't think a second dose was possable with that design auto injector. The newer ones might be different. |
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Quoted:
Quoted:
I have a question about them. How long and sharp is the needle? A friend of mine said a couple of years ago his neighbor got bitten or stung, I don't remember specifically, and called my friend to drive him to the hospital. When they first got in the truck the guy was fumbling with the pen, panicking I guess, and instead of jabbing the needle in his thigh he had the pen upside down jabbed the needle through his thumb up through the thumbnail. Is this possible? Yeah, probably. The needle on an Epipen is about an inch long (I'm guesstimating here.) If you watch the OP's video there's a demonstration of jabbing an Epipen through a piece of cardboard. When the needle is withdrawn you can see its length. (This is on an older style that didn't have a spring-loaded guard on the needle.) The needle length is fine for shooting into a thigh, shoulder, or butt. Intra-thumbical injection is contraindicated.
ETA: These guys say the Epipen has a ~0.56" needle as of 2005. My tape-measure says that could protrude through my thumbnail if I shot straight through the thinnest part of my thumb. Disclosure: Highest training, EMT We played with an expired epipen in class, the needle is about 1/2 inch long, and the directions specifically say not to put you motherfucking tumb on the end, just in case you get the wrong end under stress. Also, you are supposed to hold it in for 10 seconds and then massage the injection site. It is a vasoconstrictor, so anticipate high BP, Rapid heart rate, rapid breathing, and potential panic or anxiety. |