mycrofft
Still crazy but elsewhere
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By "cheek" did she megan gluteus maximus?
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with a needle that is either 5//8 or 7/8 of an inch long (I don't remember which) how can you put it in the cheek? Plus how would you trigger it? you can't push hard enough against the cheek to get it to fire: and if you pushed it against the gum the patient would hit you: getting a 27g needle of novacaine to numb the mouth for dental work hurts, getting a 20 g needle in the gums would feel like a railroad spike
By "cheek" did she mean gluteus maximus?
Has anyone heard of administering an Epi-Pen straight into the pt's cheek? Anyone currently do this?
There is good research about IM versus SQ epi (IM in the thigh is the way to go), and good research about the safety of IV drips of epi (Don't do boluses, lousy safety profile).
Basically no research on sublingual injections for anaphylaxis that I've ever found.
As for the cheek, no, I've not heard a thing. I wouldn't do that if I were you.
What about localized reactions such as angio edema? would direct injection Sub Q to the affected site or IM to the thigh be much more beneficial?
Epi is used locally in a few conditions. For example, epi is nebulized to treat the airway edema of croup. It is also injected into gastric mucosa under ulcers to staunch bleeding through vasoconstriction of the involved arteries.
Anaphylaxis is a systemic disease, however, so I'm not sure what role local therapy might, hypothetically, have. I've never seen any discussion of this, let alone research or evidence. Let me know if you find some!
(Sublingual injection may be in some EMS protocols, but that doesn't count as evidence!)