epi pens

[RMH4986]

in the state of ct they have an epi pen cert but it's only good for one year i was wondering if this was the same around the nation or if ct is just :censored::censored::censored::censored:ed up?

 

[Ridryder911]

Yep...

Ironic that common laymen can administer, but an EMT would have to go through a special course? Sounds, like bureaucracy at its finest!

R/r 911

 

[Capt.Hook]

In Wisconsin, our epi-pen cert is for two years. I assume you are referring to the "training" to administer? This certification is actually at our First Responder level and up from there. As FR, we need to achieve medical direction OK's to "assist" with the epi-pen, with a prescription being the most important issue. Don't know if that helps your inquiry.....

 

[RMH4986]

i know in ct that you can buy epi over the counter and you don't need a rx. tell me how that makes sence. i only asked the question b/c i was looking at day care for my son and the woman said that it was one of her certs now for me at the emt-b level it's part of my protocalls and i carry it in the jump bag. i was just wondering what it was like else were thanks for the help.

 

[VentMedic]

i know in ct that you can buy epi over the counter and you don't need a rx. tell me how that makes sence. i only asked the question b/c i was looking at day care for my son and the woman said that it was one of her certs now for me at the emt-b level it's part of my protocalls and i carry it in the jump bag. i was just wondering what it was like else were thanks for the help.

Are you complaining about a worker at a daycare center being instructed on administering an epipen while overseeing children? There should always be one person in any setting involving children who is somewhat familiar with epipens and inhalers to assist children if needed. The parents usually sign forms informing the schools or daycare centers of their child's medications and if assistance might be required. This definitely beats the old days of keeping meds out of the schools or having them locked up out of reach. By the time EMS reaches them it might be too late.

http://www.nasbe.org/healthyschools/states/Admin of Medication.html

Can you give a reference to Epipens being OTC in CT?

 

[KEVD18]

in ma, its just part of the emt course. not a seperate cert u have to re up. thats just ridiculous.

 

[VentMedic]

It all comes down to lack of uniformity in training and the 48 different certifications offered in the U.S. It would be difficult at the EMT level to ensure all had similar training for retroprocity. EMT is an entry level and a quick class to go through. Many people may hold EMT certifications for years and never work in the field. They may also work for low call areas or strictly BLS transport. Since there is very little educational prep across the board for medications for the EMT-B, I think there should be some type of recert even if it is just with the 2 or 4 year refresher course as mandated for EMT recertification. If the state offers the epipen in their EMT curriculum, then it will usually be covered in the refresher. That is of course you attend or do an online review the refresher and not just have access to someone to "sign-off" your attendance.

I have read things on the different forums and heard about things in the field that one would think should not happen when administering something as simple as an epipen.

The laypersons who have their own epipens should be fairly well informed about why they have it and when to give it.

How many hours are you talking about for the epipen recertification?

What happens if you advance to another healthcare profession that might require mandatory recerts for everything from handwashing to lifting as well as intubation and IVs? Some think getting recertified in CPR every 2 years is ridiculous also but not every EMT or Paramedic performs CPR daily, weekly or even yearly. The same can be said for ACLS, PALS and NRP certifications. Some people on this forum are in professions that require them to spend more hours each year in recertification classes than the length of the EMT-B course.

If it keeps you sharp at what you are doing it shouldn't be considered a waste of time or ridiculous.

 

[Ridryder911]

i know in ct that you can buy epi over the counter and you don't need a rx. .

Are you sure? According to the Epipen manufacture web site, they discuss that prescription is required (http://www.epipen.com/pdf/Epipen Physician Insert-1003_carrier.pdf)

I think the Daycare probably has some form of standardized education and training that allows them to purchase and administer. Then why not?

It is not the adminstration that concerns me. A monkey could administer an Epipen with ease, it is majority of cases it was never warranted. Rather than true anaphylaxis many confuse the symptoms of reactions as the same. In those cases Benadryl (which is OTC) or Pepcid, Zantac, etc. H2 blockers work as well and are safer (when administered properly).

I rarely see true anaphylaxis, and usually within the first few minutes (1-3) it is either life or death.... not a rash or hives, as some assume.

R/r 911

 

[Katie]

epipens was taught as part of our EMT-B class but it wasn't a separate cert. they did spend a fair amount of time just on how to use them but in some ways i think it's called for especially for people who have never seen or used one before.
because i have an epipen for myself i knew how to use/handle one already. but for the people in the class who had never seen them before the training was needed for proper handling. and for some reason we had several people who kept wanting to use the wrong end h34r:

 

[Jolt]

Epi-pens do require a prescription in CT. I know because just last week I had to get a new one.

There is not a separate course that CT EMTs need to take in order to administer epi-pens either. I guess that's just something you can take as a lay person similar to a CPR class.

Here is the state statute regarding EMTs administering epinephrine if anyone cares:

Sec. 19a-197a. Administration of epinephrine. (a) As used in this section, "emergency medical technician" means (1) any class of emergency medical technician certified under regulations adopted pursuant to section 19a-179, including, but not limited to, any emergency medical technician-intermediate, and (2) any paramedic licensed pursuant to section 20-206ll.

(b) Any emergency medical technician who has been trained, in accordance with national standards recognized by the Commissioner of Public Health, in the administration of epinephrine using automatic prefilled cartridge injectors or similar automatic injectable equipment and who functions in accordance with written protocols and the standing orders of a licensed physician serving as an emergency department director may administer epinephrine using such injectors or equipment. All emergency medical technicians shall receive such training. All licensed or certified ambulances shall be equipped with epinephrine in such injectors or equipment which may be administered in accordance with written protocols and standing orders of a licensed physician serving as an emergency department director.

 

[Ridryder911]

Thanks Jolt for the clarification. Really, we should not be distributing false information on this site. Unless, you really know and have documentation, one needs to know for certain before posting, we need to quit trying to give out second hand information.

A little Google, and even looking at the distributors web site will tell you it is only a prescribed medication.

R/r911

 

[VentMedic]

I think the argument has now been made with Rid's post as to why appropriate training/education is needed initially as well as a refresher periodically whether it is a service's continuing inhouse education or a formal recertification.

It is important to review medications, even if it is "just an epipen" as some view it, since they can change manufacturers, packaging and availability. It is also always good to review the dosages especially if you carry both adult and pedi epipens.

 

[bassman1490]

i am cert in epi pen and right now im doing ride alongs and my captain told me that i am not aloud to admininistor it even though im cert. when i get my emt-b cert will i be able to administer it or do you have to be a ALS tech

 

[wlamoreemtb]

i know in nj as emt-b with the cert you are allowed and as far as i know ny is the same way i jus got my ny cert yesterday so im still reading protocols

 

[rhan101277]

We are learning about this drug to in class. During a severe allergic reaction, your blood vessels constrict, bronchioles constrict etc. To combat this you give epi, which increases heart rate, dilates bronchioles and increases BP. I don't know the complete physiology behind this medicine but to me it seems giving it would cause a already high blood pressure to go even higher. Seems like it would be contraindicated with people who have atherosclerosis. Also I wonder about a increased chance in fatty deposits breaking loose causing blood clots. I guess having your pt. respirations stabilized and regular with high blood pressure is better than not giving them the drug and they die anyhow. It just seems to me that it is a very dangerous drug.

 

[KEVD18]

another moldy oldy......

 

[TransportJockey]

In NM our basics are allowed to use Epi-pens and draw up Epi 1:1000 in 0.3cc syringes and administer it ourselves

 

[Cross924]

Allergic Reaction, Anaphylaxis.

When the body experiences a severe allergic reaction or anaphylaxis the bronchioles constrict causing dyspnea and s.o.b. yes but the peripheral vascular system especially dilates causing a drop in pressure (if anything). When epi is administered it constricts the blood vessels and increases the contractile force of the heart and blood pressure.

 

[HeavyCrow]

In North Carolina we are trained that we can "help pt administer their own prescribed epi-pen" but the department I am with has standing order/written protocol that with s/s of anaphylaxis I am allowed to admin adult epi or epi-jr auto-injectors that we have on the truck. It does get confusing from state to state. especially when our instructor told us what we learned in textbook and class were just guidelines and that we would see a lot of changes in the field.

 

[Ridryder911]

i know in nj as emt-b with the cert you are allowed and as far as i know ny is the same way i jus got my ny cert yesterday so im still reading protocols

Sorry to be a pain, but why are we re-opening statements and apparently no-one reading the previous posts. Also, check your spelling and typing. Nothing removes the doubtfulness of knowing something and not being able to type a sentence.

When the body experiences a severe allergic reaction or anaphylaxis the bronchioles constrict causing dyspnea and s.o.b. yes but the peripheral vascular system especially dilates causing a drop in pressure (if anything). When epi is administered it constricts the blood vessels and increases the contractile force of the heart and blood pressure.

Are you sure that the arteries dilate? Causing an increase in blood pressure?... Again, be sure to check the facts! Remember the s/s are being dry flushed skin? Again, if you don't know the details don't post! Erroneous information is being repeated...

I would go into detail of how histamine response of protein allergens and Mast cells and the increase of basophils causes a shift and so on but doubt most would read it, understand it or better yet remember it, so look it up and learn it!

R/r 911