[video=youtube_share;OBRNyNSg2GY]https://youtu.be/OBRNyNSg2GY So I've never posted a video here so forgive me if I'm doing it the wrong way. I made a YouTube video about an alternative therapy to the EpiPen given its recent popularity in the news lately.
As required by AN, there is a link to all nurses in the description and the video itself :)
I'd appreciate any feedback you might have. I know some of you will have some constructive criticism, but please keep it friendly.
I made this video very fast because it's a hot topic right now and I didn't want to miss out. A video will usually take me 2 weeks to edit, gather material, voice over and other stuff. I made this whole video in 5 hours, so I apologize for any mistakes you might find :)
As a person who has used epi pen and the draw your own method...when in the middle of an attack ( allergy to shellfish) there is no calm and safe time to think about how to do the steps for filling a dose, and in a pre filled case, readying a needle. This is why the auto injectors are so useful and why they are recommended. When you are struggling to breath, there is very little going through your head other than...OMG I can't breath! To expect a lay person to complete an injection, in those circumstances, is asking a lot. IMHO the manufacturers of Epipen, should be regulated, or another competitor found. However that needs to be done. The auto injector is used so widely because it works and saves lives.
Specializes in ER, PCU, UCC, Observation medicine.
Studies from Thailand won't be helpful in the event of a liability case, it is more likely guidelines from American experts such as the National institute of Allergy and Infectious Disease NIH Gov would be used and their guidelines advise using an auto-injector for management of out of hospital anaphylaxis.
You need to stop with the whole liability thing. Giving advice is not a liability. If someone was interested in this method, they still need to see their doctor, talk about this alternative and get a prescription for it. The prescriber takes the liability when prescribing. With any prescription, education on its use and safety should be discussed. If giving advice was a liability Dr Phil would have lost his license a decade ago. lol.
Specializes in ER, PCU, UCC, Observation medicine.
As a person who has used epi pen and the draw your own method...when in the middle of an attack ( allergy to shellfish) there is no calm and safe time to think about how to do the steps for filling a dose, and in a pre filled case, readying a needle. This is why the auto injectors are so useful and why they are recommended. When you are struggling to breath, there is very little going through your head other than...OMG I can't breath! To expect a lay person to complete an injection, in those circumstances, is asking a lot. IMHO the manufacturers of Epipen, should be regulated, or another competitor found. However that needs to be done. The auto injector is used so widely because it works and saves lives.
Understood, there is panic. But in the same amount of time it takes to arm your EpiPen, in a pre filled syringe with a needle already loaded, all one has to do is remove the safety cap and inject.
There are a greater number of things that can go wrong though...1. Contamination, 2. The whole set is less sturdy...the auto injector is designed to be held to your thigh but can take a hit if a panicked person uses it, a pre fill you do yourself probably won't. 3. Needle size, depth, etc..also damage...
there is a reason why auto injectors are so popular. They work well. They are easy to use. They are safe in your purse or pocket..even for kids.
With the concessions being made in the face of the backlash, I feel that others out there are already moving to produce other products. A quick scroll through Google shows dozens of auto injectors for sale at about 40.00 that can be pre filled with any med...and are much safer to carry around.
Specializes in ER, PCU, UCC, Observation medicine.
There are a greater number of things that can go wrong though...1. Contamination, 2. The whole set is less sturdy...the auto injector is designed to be held to your thigh but can take a hit if a panicked person uses it, a pre fill you do yourself probably won't. 3. Needle size, depth, etc..also damage...
there is a reason why auto injectors are so popular. They work well. They are easy to use. They are safe in your purse or pocket..even for kids.
With the concessions being made in the face of the backlash, I feel that others out there are already moving to produce other products. A quick scroll through Google shows dozens of auto injectors for sale at about 40.00 that can be pre filled with any med...and are much safer to carry around.
I agree, the EpiPen would be my first choice if I needed one. It's like comparing a car. EpiPen is the rolls Royce, and this method is the run down Honda Civic. They are both cars, they will both get you from A to B, but one is much more nicer and polished compared to the other.
The whole issue is that the pharmaceutical company has increased the price to $600!
As the OP stated, this is not the ideal, it IS an alternative. I stand behind my statements.
And...as I stated (and cited):
Epinephrine prefilled syringe is an alternative treatment for anaphylaxis patients. The objective of the present study was to evaluate the stability and sterility of epinephrine prefilled syringe. Epinephrine prefilled syringe was kept in the pencil box to prevent from light exposure. The active ingredients, integrity and level of potency were measured by high-performance liquid chromatography (HPLC). The sterility was accessed by aerobic bacteria and fungi culture. The epinephrine concentration at 1, 2 and 3 months after the preparation was 101.36, 99.31 and 101.09%, respectively (acceptable range 90 - 110%). The pH was 3.17 - 3.23 (acceptable range 2.8 - 3.6). Nor-epinephrine was undetected. The cultures for bacteria and fungus were both negative. Consequently, epinephrine prefilled syringe was stable and sterile at least three month after preparation. Epinephrine prefilled syrine is an alternative low cost treatment for anaphylaxis patient.
This citation is from a research study cited by the National Institutes of Health. Though done in Asia, it is a scientifically proven study.
And yet another study:
To study the stability of epinephrine solution in unsealed syringes under conditions of high ambient temperature, low vs high humidity, and light vs dark.
Forty unsealed syringes each containing an epinephrine dose of 0.3 mg (as a 1-mg/mL epinephrine solution) were stored at 38 degrees C for 5 months, with 10 syringes at each of 4 different standardized storage conditions: dark and light at low (15%) humidity and dark and light at high (95%) humidity. Duplicate syringes were removed monthly from each storage environment and analyzed for epinephrine content vs control syringes.
The epinephrine dose, expressed as the percentage remaining of the mean control dose, was below compendial limits (90% to 115% of label claim) by 3 months after storage at 38 degrees C and low humidity and by 4 months after storage at 38 degrees C and high humidity. Light had no significant effect.
In hot climates, if an unsealed syringe prefilled with an epinephrine dose is provided for the first-aid treatment of anaphylaxis, it should be replaced every few months on a regular basis with a new syringe containing a fresh dose of epinephrine.
[h=4]Affiliation[/h]College of Pharmacy, Nova Southeastern University, Fort Lauderdale, Florida, USA.
Where is the North American research showing that the method shown in the video is a safe way for lay people to store and use epinephrine? Was the method approved by any pharmacists?
Why when we are discussing what someone does in their own homes, an issue? Insulin has long been drawn up by lay people and it sits around for up to a month?
I'm trying to understand what you feel an alternative would be??
And both of my latest citations are from North American sources.....?
I am baffled by the mentality of some of the posters here... Several posts ruminate on liability while others attempt to negate the validity of research merely because it is conducted outside of the US. Sorry to spoil the the chauvinistic beliefs of some of the people here, but please cite evidence supporting the assumption that the US is the epitome of empirical literature and medicine, and thus all research conducted out of its boarders is therefore automatically obsolete and inherently flawed.
As for the purported liability - again, another hyped-up motif all too common in American culture. As stated, this is a valid alternative to the epi-pen, albeit, as the OP admitted, it has its drawbacks. That being said, due to the current price-gouging of the EpiPen, many will have to go without, and thus this method is definitely better than nothing at all. Moreover, the OP made a great point in that the prescriber will be responsible for any liability that might exist (if any) if a person were to inject the incorrect dose for example.
Specializes in ER, PCU, UCC, Observation medicine.
I am baffled by the mentality of some of the posters here... Several posts ruminate on liability while others attempt to negate the validity of research merely because it is conducted outside of the US. Sorry to spoil the the chauvinistic beliefs of some of the people here, but please cite evidence supporting the assumption that the US is the epitome of empirical literature and medicine, and thus all research conducted out of its boarders is therefore automatically obsolete and inherently flawed.
As for the purported liability - again, another hyped-up motif all too common in American culture. As stated, this is a valid alternative to the epi-pen, albeit, as the OP admitted, it has its drawbacks. That being said, due to the current price-gouging of the EpiPen, many will have to go without, and thus this method is definitely better than nothing at all. Moreover, the OP made a great point in that the prescriber will be responsible for any liability that might exist (if any) if a person were to inject the incorrect dose for example.
Graduategalen
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As a person who has used epi pen and the draw your own method...when in the middle of an attack ( allergy to shellfish) there is no calm and safe time to think about how to do the steps for filling a dose, and in a pre filled case, readying a needle. This is why the auto injectors are so useful and why they are recommended. When you are struggling to breath, there is very little going through your head other than...OMG I can't breath! To expect a lay person to complete an injection, in those circumstances, is asking a lot. IMHO the manufacturers of Epipen, should be regulated, or another competitor found. However that needs to be done. The auto injector is used so widely because it works and saves lives.