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Discussion

Epi for all?

Am i over thinking this?

I work front office while i go to school, so i did not get to express an opinion at work, but i dont understand the following.

Pt calls asking for an Epipen.

Have you ever used an epipen before? No.

Do you have allergies? No.

Why do you need an Epipen? I saw a beehive on my street.

Are you allergic to Bees? No.

I am afraid i am not following, what will you use the epipen for? In case someone on my street or my roommates gets stung, i will use it on them.

I send back the message. The Dr. has an epipen called in for him no questions asked.

There was no discussion with him about how to recognize an anaphylactic reaction. or when to use the pen.

Is this usual? I understand the logic, but is it really safe to put a dangerous drug in the hands of someone who knows nothing about it? are the in such small dosages that you could not do lasting harm if it was given for the wrong reasons? by this logic, should everyone have an epipen?

Thanks for your input!

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    • Featured Replies

    Should have said something to MD. Depends I suppose on how you judge his willingness to listen. If you were a nurse, definitely should have intercepted it. Like called the pharmacy and spoken to pharmacist. Tough call though in your situation since you don't have a "legal duty" that you can lean on for support.

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    • Author

    Thanks for responding!

    I am floating, so I had never been in this office before. When I started nursing school, my supervisor had given me a talk about not exceeding my "scope of practice" as a receptionist. My clinic creates these artificial barriers between staff. e.g. Some offices will not give the MD extensions to the reception staff. All communication has to go through the MA. I did tell the MA about this, but all she did was que up the rx in EPIC. I just feel really awkward about it. I did the CYA routine and documented the conversation with quotes from the pt and his responses to my questions. You know, just incase he hospitalizes someone with seasonal allergies.

    Maybe next time we have an ethics discussion in class, I can bring this up!

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    Most people don't know they have a severe allergy until it's too late. I think the more people have an Epipen the better. There's no harm in a just in case Epipen. The doctor takes an oath to first do no harm, and i don't see that he did. I think it should be done more often.

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    • Admin

    Prescription before diagnosis=malpractice.

    ;)

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    It's surprising to me that the MD was willing to prescribe that without seeing the patient. I've seen some people have very bad reactions to being given epi when they did not need it. If it was ok to give epi-pens to everyone, they would be sold over the counter, and of course we know even over the counter medications can be extremely harmful when used at the wrong time. plus, the idea that they would just use the pen on someone else? It is prescribed for that patient, not just anyone...

    I wonder if the MD is trusting the MA too much and just signing stuff?

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    • Guides

    I work in an allergy practice and we will only rx epi-pens to those with documented food allergies, stinging insect allergies, and some chemical allergies. We do rx them to all patients receiving immunotherapy. It is not a benign medication and should not be treated as such.

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    Sorry, but aren't I correct by saying giving epinephrine to someone with certain health conditions, such as a pre-existing heart condition, can have severe side effects? Even deadly side effects?

    And if one doesnt know how to use it, for example instead of into the thigh they do it into the chest, it can cause...well, severe problems? Or if they use an adult epi-pen on an infant...........

    If something went wrong, and the epi-pen was traced back to the doctor he could loose his license, or worse.

    I understand your predicament though!

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