Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Tuesday, April 14, 2009
    "I Didn't Know it was Loaded!"

    According to this report, it's becoming more common for patients to inject themselves accidentally with EpiPens. EpiPens are preloaded syringes of epinephrine which can be prescribed to patients who have severe allergies (i.e., bee stings or food allergies such as peanuts). The epinephrine is supposed to reverse the effects of anaphylaxis, ease breathing and give the patient time to get medical help. While undeniably useful, I have often wondered if these pens are over prescribed - I get a lot of requests for them. Surely not everyone is that allergic to bees? At any rate, the study reviewed 26 reports on accidental autoinjections, culled from medical journals over the past twenty years.

    About 94 percent of these injections went into the thumb or finger instead of the thigh, where they are supposed to go. Fortunately not a lot of side effects were noted, "pins and needles" sensation being the most common. I was wondering if there had been any episodes of blood loss to the finger! I was always taught that using epinephrine to a "dead end" part of the body like the finger was a no-no as it could compromise the blood supply. No such complications were mentioned in the article, however.

    If you are severely allergic to something, you probably need one of these pens. My preferred treatment, though, is liquid Benadryl (diphenhydramine). It's easy to swallow and gets into your system faster than the pills. I often recommend it as part of a travel medicine kit.




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