Comments on: Epinephrine, Not Antihistamines, Remain the Treatment for Anaphylaxis http://www.wildmed.com/blog/epinephrine-not-antihistamines-remain-the-treatment-for-anaphylaxis/ Face any challenge, anywhere. Thu, 22 Dec 2011 03:54:14 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Frankie http://www.wildmed.com/blog/epinephrine-not-antihistamines-remain-the-treatment-for-anaphylaxis/comment-page-1/#comment-7552 Frankie Sun, 30 May 2010 17:04:53 +0000 http://www.wildmed.com/blog/?p=868#comment-7552 mccand: waiting until a person is unconscious or not breathing to admister epi for anaphylaxis is foolish, irresponsible, and medically incorrect. Epi is not a "dangerous drug," as you claim, but waiting until your patient is on death's door to adminster epi is, most certainly, a dangerous practice. On my recent WFR course, our instructors were very clear on when to adminster epi: "at the first sign of anaphylaxis." They also made it clear that you can wait too long, at which point not even the best hospital in the world can save your patient. Please get educated and your facts straight before you spew more scientifically devoid medical advice on this website mccand: waiting until a person is unconscious or not breathing to admister epi for anaphylaxis is foolish, irresponsible, and medically incorrect. Epi is not a “dangerous drug,” as you claim, but waiting until your patient is on death’s door to adminster epi is, most certainly, a dangerous practice. On my recent WFR course, our instructors were very clear on when to adminster epi: “at the first sign of anaphylaxis.” They also made it clear that you can wait too long, at which point not even the best hospital in the world can save your patient.

Please get educated and your facts straight before you spew more scientifically devoid medical advice on this website

]]> By: mccand http://www.wildmed.com/blog/epinephrine-not-antihistamines-remain-the-treatment-for-anaphylaxis/comment-page-1/#comment-6205 mccand Fri, 09 Apr 2010 12:55:57 +0000 http://www.wildmed.com/blog/?p=868#comment-6205 I agree completely with the sentiment: Anaphylaxis should get epi. Properly trained people should probably carry epi when dealing with groups of people outside easy access to EMS The problem I have encountered, and that others have recounted to me is this: Most people who ask you to carry epinephrine ARE NOT PROPERLY TRAINED to use it. Many people are unable to distinguish between a normal allergic reaction, and anaphylactic shock. In many cases guides will carry epi and administer it for anything that remotely resembles an allergic reaction. "He's getting hives!" Poke. "His lips are swelling!" Poke. "He's having trouble breathing" (Wheezing) Poke. I any of these cases, the patient's impending panic attack and high blood pressure is not really going to help the situation. In fact, I have seen reports from incidents where responders gave epi in cases when it was not indicated, realized that the epi had not solved the problem, THEN GAVE THE PATIENT ANOTHER DOSE. I have two rules on my trips: 1) If a person has a known life-threatening allergy, and carries their own prescription for epinephrine, they may use it at their discretion. 2) If the patient is conscious and breathing, you shouldn't administer epinephrine. Treat the symptoms appropriately, and if the patient goes into shock or stops breathing, THEN you can give them epi. Unless you are a registered paramedic, physician, or are adequately trained AND operating under a physican's license, and you break these rules, 1) You may be practicing medicine without a license, 2) You may be legally liable for any harm done to the patient, 3) You may be committing negligence, practicing beyond your level of training, and 4) You may not be protected by applicable "Good Samaritan" laws in your state. Bottom line: People forget that epi is a dangerous drug, that can solve one problem well in the wilderness setting, and make lots of other problems worse. I agree completely with the sentiment: Anaphylaxis should get epi. Properly trained people should probably carry epi when dealing with groups of people outside easy access to EMS

The problem I have encountered, and that others have recounted to me is this:

Most people who ask you to carry epinephrine ARE NOT PROPERLY TRAINED to use it. Many people are unable to distinguish between a normal allergic reaction, and anaphylactic shock.

In many cases guides will carry epi and administer it for anything that remotely resembles an allergic reaction. “He’s getting hives!” Poke. “His lips are swelling!” Poke. “He’s having trouble breathing” (Wheezing) Poke. I any of these cases, the patient’s impending panic attack and high blood pressure is not really going to help the situation. In fact, I have seen reports from incidents where responders gave epi in cases when it was not indicated, realized that the epi had not solved the problem, THEN GAVE THE PATIENT ANOTHER DOSE.

I have two rules on my trips:
1) If a person has a known life-threatening allergy, and carries their own prescription for epinephrine, they may use it at their discretion.
2) If the patient is conscious and breathing, you shouldn’t administer epinephrine. Treat the symptoms appropriately, and if the patient goes into shock or stops breathing, THEN you can give them epi.

Unless you are a registered paramedic, physician, or are adequately trained AND operating under a physican’s license, and you break these rules,
1) You may be practicing medicine without a license,
2) You may be legally liable for any harm done to the patient,
3) You may be committing negligence, practicing beyond your level of training, and
4) You may not be protected by applicable “Good Samaritan” laws in your state.

Bottom line:

People forget that epi is a dangerous drug, that can solve one problem well in the wilderness setting, and make lots of other problems worse.

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