In The Great White North Posted January 18, 2012 Share Posted January 18, 2012 So, all the threads about allergies, schools, epi-pens and kids dying without them, I've been wondering: why are they so tightly controlled? Will a person DIE if they are given an injection from an epi-pen but don't NEED it? Can kids actually get high from them? Is there a black market I'm unaware of? What is the rational for the government in general and individual schools in particular to limit access to epi-pens AT ALL that could possibly outweigh a child dying because their epi-pens wasn't in the right place at the right time? Since so many "first reactions" are serious, why do they even require a prescription? Why aren't they in every first aid kit? Quote Link to comment Share on other sites More sharing options...
Tigger Posted January 18, 2012 Share Posted January 18, 2012 The epinephrine in the pen can cause cardiac rhythm problems and/or cardiac arrest; also there can be severe swelling at the site of injection to the point of restricting blood flow if injected in, say, a finger. It is considered an emergency situation of someone, child or adult, is accidentally injected - they need to go to the ER for monitoring and will usually be given nitroglycerin to counter the epinephrine if there are cardiac symptoms and can be give phentolamine to help reverse any issues with blood flow around the injection site if that's causing a problem too. Quote Link to comment Share on other sites More sharing options...
Spryte Posted January 18, 2012 Share Posted January 18, 2012 That's a good question. As a mom of a kiddo with LTFA (life threatening food allergies), and a daughter of of someone with LTFA, I would personally like to see epi-pens more readily available. I can say that I know of a 5 year old who gave herself her epi-pen just to see how it would feel - and other than getting the shakes, she was fine. There was a trip to the ER, to be sure she was okay, but other than that - she was fine. That said, though, I do believe that if a person has certain conditions, an epi-pen injection might have potential effects that are not healthy. Tigger covered that well. No idea whether kids can get high somehow though. Our choice to homeschool was not based only on epi-pens in classrooms, but finding out that our local school did not allow them in the the classroom was a huge factor. I haven't read the other threads, so this may have been pointed out already... but at a bare minimum, it would be nice to see epinephrine on every ambulance. In some states, when calling 911, we have to know to let them know that there is anaphylaxis, and that epi may be needed. Such a basic life-saving med should be available for 911! Quote Link to comment Share on other sites More sharing options...
LMA Posted January 18, 2012 Share Posted January 18, 2012 Actually, you are supposed to go to the ER immediately after using an Epi-Pen whether or not you are accidentally injected. The insert in the package says so. So even if you are supposed to use one with a life-threatening allergy, you need to go to the ER. Quote Link to comment Share on other sites More sharing options...
Spryte Posted January 18, 2012 Share Posted January 18, 2012 Actually, you are supposed to go to the ER immediately after using an Epi-Pen whether or not you are accidentally injected. The insert in the package says so. So even if you are supposed to use one with a life-threatening allergy, you need to go to the ER. Yes. ...I just re-read my post, with the story of the little girl, and that wasn't clear. That is absolutely true. Quote Link to comment Share on other sites More sharing options...
TravelingChris Posted January 18, 2012 Share Posted January 18, 2012 I don't really understand the question. Epipens and asthma inhalers, while both are prescription drugs, are the two exceptions I have always seen in any situation where most drugs are needed to be turned into school nurse or camp nurse. My youngest who needs to carry an epipen and an asthma inhaler is always allowed to do that. My middle attended a summer program at a public school and so I saw the rules for them. Again, epipens and asthma inhalers were the exceptions to bringing in drugs to school. They still needed a doctor note but if your child has either potentially fatal allergies or asthma, you do take them to doctors. The doctors are so used to writing the notes that even though we homeschool, they always want to give us the note. Now as to the question of whether they should be prescription medicines or not, the US has very strict controls on medications. OUr controls are stricter than most countries. The thinking here is that since doctor visits are costly, people who really need to be seen by doctors would forego the visits and just get the medications. In other countries, doctor visits are much, much cheaper and I guess they don't think that is a problem. Quote Link to comment Share on other sites More sharing options...
MedicMom Posted January 18, 2012 Share Posted January 18, 2012 I have life threatning allergies and carry two epi pens with me. I am also a paramedic. Epinephrine is a vasoconstrictor. It can cause cardiac issues, including a heart attack, because the cardiac veins clamp down. This complication is usually only seen in people with underlying cardiac disease, usually people over the age of 45. I have never seen or heard of it in a child. Every ambulance in every state is requiered to carry epinephrine. It may not be in an Epi Pen forn, it may be in a vial and injected through a regular needle like the one they use for vaccines. But every advanced life support, and every basic life support ambulance in every state I know of, carries Epi. We as paramedics need to know as the uae of an epi pen means this was more than a mild localized allergic reaction and we may need to be ready to aggresively manage this patient's airway and blood pressure. It is also helpful to know before we arrive what medications the pt has taken, and Epi falls into that. Some systems have different protocols based on whether or not Epi has been given prior to our arrival. As far as why so tightly controlled, my guess is fear of lawsuits. Quote Link to comment Share on other sites More sharing options...
Beach Mom Posted January 18, 2012 Share Posted January 18, 2012 A bill has been introduced in both houses of congress to address the issue of epi-pen availability in schools. It is called the School Access to Emergency Epinepherine act. You can read the proposed legislation here: http://www.gpo.gov/fdsys/pkg/BILLS-112s1884is/pdf/BILLS-112s1884is.pdf Quote Link to comment Share on other sites More sharing options...
wapiti Posted January 18, 2012 Share Posted January 18, 2012 . Quote Link to comment Share on other sites More sharing options...
Runningmom80 Posted January 18, 2012 Share Posted January 18, 2012 The epinephrine in the pen can cause cardiac rhythm problems and/or cardiac arrest; also there can be severe swelling at the site of injection to the point of restricting blood flow if injected in, say, a finger. It is considered an emergency situation of someone, child or adult, is accidentally injected - they need to go to the ER for monitoring and will usually be given nitroglycerin to counter the epinephrine if there are cardiac symptoms and can be give phentolamine to help reverse any issues with blood flow around the injection site if that's causing a problem too. This is not true. The only contraindication is if you have an existing heart problem. For everyone else, the side effects are minimal and harmless. To answer the OP, there is currently legislation in the works to make epi pens available in every school. Quote Link to comment Share on other sites More sharing options...
Runningmom80 Posted January 18, 2012 Share Posted January 18, 2012 And the reason you need to go to the ER after you use one is because there can be a second (biphasic) life threatening reaction. You need to be monitored for this. Quote Link to comment Share on other sites More sharing options...
Laura in MI Posted January 18, 2012 Share Posted January 18, 2012 From what I know the side effects are minimal except for people with heart conditions. Everyone has to go the ER after being injected to monitor for any other reaction. At our public school, they allow kids with Asthma to carry their inhaler and use it even when they're not having an asthma attack but not epi-pens. I think that's crazy.. Quote Link to comment Share on other sites More sharing options...
sbgrace Posted January 18, 2012 Share Posted January 18, 2012 (edited) From what I know the side effects are minimal except for people with heart conditions. Everyone has to go the ER after being injected to monitor for any other reaction. At our public school, they allow kids with Asthma to carry their inhaler and use it even when they're not having an asthma attack but not epi-pens. I think that's crazy.. Michigan (and 48 other states) have laws to protect a child's right to carry an epi pen on their person. I'd think your school just needs educated as to their state law? http://www.aanma.org/advocacy/meds-at-school/ OP, the legal push right now (outside of the NY and RI needing pass a right to carry law for epi pens) is for stock epis at schools. I hope this happens. Edited January 18, 2012 by sbgrace Quote Link to comment Share on other sites More sharing options...
Spryte Posted January 18, 2012 Share Posted January 18, 2012 (edited) Our local schools require epis and inhalers to be locked up in the nurse's office. Which in turn is locked if the nurse is not inside. Too many locks for life saving meds! Ambulances - in several states, only advanced life saving ambulances carry epinephrine. NY just changed that in May, 2010: http://www.foodallergy.org/page/emergency-medical-services PA and VA were 2 more examples, and I have not heard that they've changed, although it's possible. Per our allergist, we are to request ALS ambulances when we call 911. Hoping that my info is old now, and that all states require epinephrine on ambulances, that NY was the last to change... But just in case, people do need to be aware that some states may not carry epi on board. Edited January 18, 2012 by Spryte Quote Link to comment Share on other sites More sharing options...
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