Oct. 26th, 2014

c1: (Star of Life)
We carry epi-pens; both adult and child sized. (Kiddos get half the dose.) Everyone at my service has standing orders to use them when needed; there's no question of whether the practitioner is a basic EMT or a paramedic, it's in our scope of practice at all levels.
So they're neat in how they work (both mechanically and on the body*) but I'd never actually seen one do its thing, nor have I ever used one in the field. In class yesterday, that got corrected to a certain degree.
No kidding, we set up a target and used a paper coffee cup to trigger the firing mechanism. If you don't know, it's about the size of a large magic marker, and you press the end into the patient's thigh, whereupon a mechanism shoots a spring-loaded needle into the patient, injecting the person with epinephrine intra-muscularly. So I pressed the gizmo into the end of the paper cup, and from about 5 feet away (wow!) doused the target with the juice. (The cops in the class were giving me some friendly grief about "aiming for centre of mass", "get a good sight picture", and so on. They're good guys, and fun to be with.) We were using "real" epi-pens that were out of their expiration dates, so this was as good as the real thing.
One guy in class has felt the "wrath" of the 'pen's needle. It's not particularly small, needing to be able to penetrate clothing, so it shoots out about 1/2-3/4 of an inch. In his case, this was unpleasant, but far more pleasant than the anaphylaxis he was experiencing at the time.

No shift on the trucks last night -- third week of the month is an unscheduled week.

*Epi doesn't work forever, so we were reminded that the patient may want to decline transport, but we should try to convince the patient otherwise; some allergens can have a drawn-out affect on the body, or even bi-phasic, and just because we shot them once or twice with epi doesn't mean they're out of the woods. Ideally, they get monitored in the ER for a good four hours or so just in case they experience a recurrence of symptoms.
We were also cautioned about the trigger: a non-trivial number of practitioners have shot themselves in the thumb, with "entertaining" results. "How's that shot of epinephrine doing for you?" 

November 2014

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