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Look at it this way, the dosage for epi in anaphylaxis for pedis is 0.01mg/kg so at 50 lbs that's approximately 22.5kg so 0.23mg. that's right in between pedi and adult epi pens (0.15 and 0.30 respectively).
What if the child weighed approx. 30 lbs (per mother of child)?
What if the child weighed approx. 30 lbs (per mother of child)?
Hmmmmmm. Got pediatric bendaryl orders?
Sidebar: while it is usually a bad idea to try to titrate antidotes without advanced life support or at least white tile and plenty of nurses around, is there something which could be given to soften the cardiac effects of epi? IS it worth the risk versus time for transport?
I would give it. With my transport times ( min 2 hours on a very good day)waiting would not be an option. Then again this would not happen to me as I draw meds and can also do iv/io epi if needed.
As for the 30 lb that would make me hesitate and administering it (adult epi pen)would depend on a number of variables . Distance to hospital , severity of reaction, progression, pts past hx. Is there a way to break into the pen and draw up the epi from there.
I can see this being a very difficult call for a BLS crew. Especially if you have a long transport an no ALS backup.
Dishcharge the epipen into a red top blood tube (no additives) then draw it up with a syringe? Ask your medical controller.
What would you do if you took a "bee sting call" and found a child (50 lbs) with obvious signs of severe anaphylaxis and all you carry on the truck are adult epi-pens?
As far as dose. An overdose of epi might (very small chance) kill a pedi. True anaphylaxis that's left untreated WILL kill your patient.