Questions for EMTs/Medical Pros on backcountry anaphylaxis treatment

[Tod osier]

How much are they? You can buy a 50 ml bottle for $25.

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Someone above said 400 for a pair.

 

[Rob5589]

How much are they? You can buy a 50 ml bottle for $25.

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Curious, where are you buying 50 ml's of epi 1:1000 for 25 dollars?

 

[ShakeDown]

Mexico ^

 

[Rob5589]

Mexico ^

I'll pass...

 

[Marbles]

A 1 mg vial of IM epi is $1.25. the pens have a hell of a premium and the cheap pen is $400. They use to be cheaper.

 

[Unclemoe]

This summer go to your doc tell them you got stung by a bee and swoll up alot by the site and it was the first time you got stung and are worried you are allergic. Doc will most likely write u a RX for and epi pen prior to sending you for the test, you get the RX filled take the test and find out your not allergic but have the pens anyway.


Shady yes but will likey work since most doc dont wana risk you being stung again before the test is done and you die.

Reason i know is this happened to my wife.

 

[jmez]

Amerisource Bergan

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[ShakeDown]

And why is a wholesale price pertinent to the average person?

 

[Gatorgrizz27]

I was prescribed an epipen last summer after having a heat/pressure urticaria pop up. If I continued pushing it I would get lightheaded and feel constriction in my throat. I was glad to have the epinephrine but luckily didn’t have any issues in CO.

You might see what your insurance will cover, I was surprised that I paid something like $8-9 for mine, I was expecting the $25–$400 range. As has been said the storage requirements are restrictive, it’s supposed to be < 77/78 degrees with temporary excursion up to 85 allowed. Fine even in archery season, but not something you can just throw in the glovebox.

In the event of a reaction, would a nasopharyngeal airway help prevent the throat restriction, and keep the patient alive long enough for Benadryl to work, assuming you also know how to treat for shock?

They are cheap, light, available without a prescription, but I doubt you could self insert under stressful conditions.

 

[Marbles]

N

I was prescribed an epipen last summer after having a heat/pressure urticaria pop up. If I continued pushing it I would get lightheaded and feel constriction in my throat. I was glad to have the epinephrine but luckily didn’t have any issues in CO.

You might see what your insurance will cover, I was surprised that I paid something like $8-9 for mine, I was expecting the $25–$400 range. As has been said the storage requirements are restrictive, it’s supposed to be < 77/78 degrees with temporary excursion up to 85 allowed. Fine even in archery season, but not something you can just throw in the glovebox.

In the event of a reaction, would a nasopharyngeal airway help prevent the throat restriction, and keep the patient alive long enough for Benadryl to work, assuming you also know how to treat for shock?

They are cheap, light, available without a prescription, but I doubt you could self insert under stressful conditions.

No on the NPA (or an OPA), the problem is below that level.

Benadryl also will not save someone. It is an adjunct medication, the only definitive treatment is Epi. Antihistamines only target one element of a complex cascade that takes place in anaphylaxis. There is good documentation in the literature. Epi is not a bridge while benadryl takes effect, epi is the only treatment.

While I don't need to look that up, here is a supporting source as I always want documtation on such things. From Lexicomp "Administer epinephrine first when treating anaphylaxis. Do not use diphenhydramine for initial or sole treatment of anaphylaxis because H1 antihistamines do not relieve upper or lower airway obstruction, hypotension, or shock."

 

[Rob5589]

I was prescribed an epipen last summer after having a heat/pressure urticaria pop up. If I continued pushing it I would get lightheaded and feel constriction in my throat. I was glad to have the epinephrine but luckily didn’t have any issues in CO.

You might see what your insurance will cover, I was surprised that I paid something like $8-9 for mine, I was expecting the $25–$400 range. As has been said the storage requirements are restrictive, it’s supposed to be < 77/78 degrees with temporary excursion up to 85 allowed. Fine even in archery season, but not something you can just throw in the glovebox.

In the event of a reaction, would a nasopharyngeal airway help prevent the throat restriction, and keep the patient alive long enough for Benadryl to work, assuming you also know how to treat for shock?

They are cheap, light, available without a prescription, but I doubt you could self insert under stressful conditions.

The NPA sits above the tracheal opening. The only way to keep the airway open/patent is with intubation. Take a look at this pic for reference.

 

[Gatorgrizz27]

The NPA sits above the tracheal opening. The only way to keep the airway open/patent is with intubation. Take a look at this pic for reference.
View attachment 286014

Got it, thanks for the image. It’s hard to envision where it ends up based on looking at it in the package.

 

[406]

Used to be able to get epi at any vet supply/feed store. Don't know if changed, I haven't had to worry about supply in years luckily.

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[k26ON]

Another critical consideration for this discussion into wilderness first aid should be the importance of carrying VHF / UHF radios which enable you to reach outside help during any type medical emergency. Safe safe out there man!