epipens?

[twinbee]

I'm finishing my first year and was wondering what NON-allergic beekeepers think in general about keeping an epipen in the house in case of emergencies. I recently tried to get one and even with insurance covering part of the cost, it was 170 dollars, and the shelf life is less than two years from what I understand. Given that I and my family are not allergic, and the neighbors are far away, what is the general consensus on this?

[Michael Bush]

I've never seen an epipen... I saw a picture of one once on a bee forum...

[Intheswamp]

I understand your concerns twinbee. I purchased one when I first started, though my cost was much less than what you are stating...more around the $50 mark after insurance. It is a decision that you will have to make. Keeping bees around the house will mean that there *will* be more honey bees flying around the yard, it's only normal. Concern for others is natural. My pen has since expired...as of several months ago. I feel no urgent need to refill the prescription, but I may refill it one day...my choice. It's your decision...your comfort level. I would imagine that only a small percentage of beeks have epi pens on hand, though.

One caveat... If you do buy a pen, *before* you purchase it or hand over your prescription to the pharmacist, ask to see the expiration date on the pen. As you mentioned, epi pens are good for +/-18 months, but if the pen has already set on the drugstore shelf for 10 months then your getting short changed. I did not think about this until I got home with the one that I bought...when I looked at it it had something like 7-8 months left before the expiration date. I wasn't very happy about that. Next time I will ask to see the actual epi-pen that I will receive (if there is a next time). Naturally, though, "official" websites warn against administering epinephrine to other people as it itself can cause serious problems.

http://www.nlm.nih.gov/medlineplus/e...cle/000844.htm

For me, proximity to an emergency room and availability/quickness of first responders would be a couple of the considerations in the decision making process.

Best wishes,
Ed

[Tallevaguy]

I'm non allergic to bees in the sense of the need to use an epipen but I keep one for other allergies. I'm not sure that there is a need to have one unless you are in very remote area and the local EMS may be delayed coming in an emergency. FYI...there is a company that makes a generic epinephine auto inject pen that is much cheaper than the epipen and the twinject pen. I've had all thee. The cost of the generic is great for a two pack but I prefer a two pack of twinject pins...that gives me four doses.

[KPeacock]

I think it is wise to be aware of teh potential problem. it is also wise to do what you can to prevent unnecessary bee exposure to those that may have an adverse reaction to the sting. Keep water available for the bees, try to influence flight paths to avoid people..etc. If you're worried about legal issues, an individual will have a hard time proving that the stinging bee came from your hive. There are lots of bees out there that could have done it.

Fact of the matter is that cats scratch, dogs bark, and bees sting. It's just life. While i do carry a 1st aid kit and a suture kit for emergencies, I don't feel it is necessary for me to have a fast acting inhaler for the asthmatics, insulin for the diabetics, or glycerin for those with heart problems. It is my opinion that individuals at risk should prepare themselves. If I knew that i would have an adverse reaction to a sting, i would be prepared for that eventuality....apiary or not.

For transparency, I do not have bees. This is my first year messing about with these creatures and my opinion may be influenced by time and experience. For now, I say you are a good person to consider others, but you need not provide epipens for them.

[Irmo]

Just a note, epi pen prescriptions are written for the person who will use the pen (on themselves), and generally not to issue a pen to someone to have around just in case someone else needs it. Some Doctors will write a prescrition for beekeepers to have a pen on hand, others won't. If you were to use your epi pen on another person and something bad happened......misuse of a prescription drug

[Intheswamp]

<snip> If you're worried about legal issues, an individual will have a hard time proving that the stinging bee came from your hive. There are lots of bees out there that could have done it.

Fact of the matter is that cats scratch, dogs bark, and bees sting. It's just life. While i do carry a 1st aid kit and a suture kit for emergencies, <snip>... It is my opinion that individuals at risk should prepare themselves.

KP, lots of people don't know that they are at risk. People usually don't first go to a doctor or somewhere and ask to be tested for bee venom allergies...they find out they are allergic by being stung, followed by anaphylactic shock symptoms. *Then* they follow up with testing and find that they are indeed at risk. Some people who have never been allergic to bee venom one day suddenly have a very bad reaction...there have been commercial beekeepers that have given up their lifelong work because of sudden deadly allergies. A suture kit, eh?

<snip> If you were to use your epi pen on another person and something bad happened......misuse of a prescription drug

Both of the quoted posts above point to "legal" issues and rightly so. I'm not bashing either of the posters, but pointing out that worries of legal problems appear to be more important to our lawsuit-happy society today than helping someone in need. Kind of a "Dam_ the good Samaritan, I'm covering my butt" mentality.

So, for a non-allergic beekeeper... Morally right to have an epi pen?...no. Wrong not to have one?...no. Good to have?...yes Probability of needing to use it?....low. Could cause legal problems?...yes. Could save someone's life?...yes. Probability that it will expire before use?...high. Make you feel better to have one on hand?...maybe. Will you purchase one?...your decision.

Ed

[Vance G]

Legitimate hypoallergenic reactions resulting in death from bee stings are much more rare than golfers being struck and killed by lightning on golf courses. I don't see golfers carrying around grounding rods. Now if you fee tingles you get off the course or get an epipen if you have a severe reaction. But I guess I personally am just not that consumed by fear. Until you have trouble, you have no trouble. Since a huge percentage of people think pain and swelling at the point of wasp sting means they are ALLERGIC to bees. They should get epipens not you.

[Irmo]

KP, more important to our lawsuit-happy society today than helping someone in need.

Actually, I was thinking of criminal charges and jail time. But you're right, a lawsuit would stink too.

This is a tough one because we should all do everything we can to help someone in need, but where do you draw the line between doing everything and anything possible, or using good judgment while trying to help. I don't have a good answer. I do know that epinephrine is serious stuff and can be harmful to people with some reasonably common conditions (asthma, high blood pressure, and heart conditions among them). So much so that their own doctor might not give them an epi prescription of their own. Of course they will probably tell you before you jab them...unless their throat is swollen shut. Anyway, I think administering a prescription drug to someone, when it's not their prescription, is a pretty serious thing to do unless you're a Doctor or First Responder/EMT. The rest of us should be focused on getting the victim professional help as fast as possible. I don't believe that says "**** the good Samaritan".

The people I know who need an epi prescription pretty much carry the thing around with them all the time. Sometimes they forget or leave it somewhere, but generally they have it with them or nearby. Particularly when their condition is so serious that circumstances could turn deadly without it.

[Vance G]

Keep giving in and see what you got left.

[Steven Tervort]

You need a prescription for an epipen. Only 3% of the population will develop anaphylaxis when stung by bees. The chances of someone actually needing your epipen would be extremely rare... If a person is truly allergic to bees, they would more than likely be carrying their own epipen.
A lot of people believe that an epipen will fix anaphylaxis. They give the epipen but don't call 911. The epipen only relieves the shock until qualified medical personnel can help you.
Epipens contain only a single dose of epinephrine. If someone has a severe allergic reaction they will need to be given more doses until the reaction stops.
The last problem is that a lot of people don't store their epipens correctly. The epipens need to be stored at 77* Fahrenheit until the expiration date. Having one on hand every time you are in the bee yard would likely ruin the medication. If someone actually needed the epipen, it wouldn't work.
***Just sharing the info I received from my Doc when I asked about it*** You can find more information on the epipen website (www.epipen.com)

[Tallevaguy]

Epipen = one dose, auto injected.
Twinject pen = one dose, auto injected and a second dose if needed manually injected.
Generic pen = one dose, auto injected.
If you feel the need to give yourself a shot with one of these pens, you need to get to an ER for futher evaluation. One poster said the pen prolongs the symptons, it actually relieves the shock for a small period of time. It the reaction is severe enough, it will just come back and need attention again...thus the need to get advanced medical help.

Through the years I have attended CPR/AED/first aid classes this question has come up about someone giving another person a shot with his / her epipen. The answer has always been that it is not legal. If you have a pen and someone else needs it, it has been recommended that you prepare the pen for use and had it to the person in need and if the person in need has stopped breathing, wrap thier hand around it and help them stick themselves. This is ONLY what the instructor was telling us. It is not legal, it's a possible life saving measure that you may have to defend.

[KPeacock]

Ed,

You make soem good points about others being unaware of their potential reaction.

The suture kit is just a matter of convenience. I've only used it once to save a long trip out of the woods and a long wait in the ER. My hobbies/habbits result is injuries to my hands more than anything. it's darn hard to stitch yourself up with one hand. I'm not sure I'd attempt it unless it were an emergency.

[Vance G]

3% of the population is a wild wild exageration!

[Verick369]

I am an aspiring beekeeper, and a pollination ecologist. From all the literature I have read about bee venom if you are stung regularly (1+ times per month,) your odds of having a reaction are well under 1%. However, individuals who are stung infrequently (especially those who are stung only once per year,) may have a chance as high as 90% of going into shock over that time period. This is why beekeepers families are generally at the highest risk. People may develop an allergy, or just have a bad day. I have met a few beekeepers who went into shock after working with bees for years seemingly out of the blue, and not a single one of them were proud of their lack of an epi pen. One guy I knew passed out in front of a clinic at the school he was working out, and if he had been out in a field somewhere it could have ended very poorly. In the end you should assess the risks and benefits and decide on your own, but I will always pay the money to ensure nothing terrible happens to me or anyone I work with or know.

[Luterra]

Allergy threads tend to bring out strong opinions...

I realize it is technically illegal to administer an epi-pen on someone else. That said, 1) the benefit-to-risk ratio of epinephrine injection during anaphylaxis is much higher than is being stated here, and 2) epi-pens are all the same, with the exception of a lower-dose version for children. Therefore if I am having an allergic reaction I want the nearest epi-pen ASAP. I don't care if it is mine.

Most complications from epi-pen injection arise when it is injected into a finger. This happens surprisingly often as in the heat of the moment folks get the pen upside down, jam it into their thigh, and the needle goes right through their thumb. Epinephrine is a powerful vasoconstrictor; the result is no blood flow to the affected finger and it turns white and cold. This is not life-threatening but does often require medical treatment.

I don't think the 3% figure is too high, but all allergies are not created equal. Which is to say that the proportion of people who would die if stung with no epi-pen is less than 1% while the proportion who have experienced allergy (i.e. systemic symptoms like full body rash after a sting) is much higher, especially among beekeepers. I developed an allergy to stings two years ago, went through desensitization, and have had more than 70 stings since with no adverse response.

I try to post these links in every allergy thread. Good info from an MD beekeeper. If you only have time to read one, read the second one.
http://www.cals.ncsu.edu/entomology/...06a%20copy.pdf
http://www.cals.ncsu.edu/entomology/...06b%20copy.pdf

[RiodeLobo]

Yes you could get in legal or civil trouble if you inject someone with an epi-pen that is not theirs (after all you could actually kill someone with one), unless you are medically trained and in your field of expertise. That being said I would not hesitate to use one (since I have them on hand, due to an allergy) if the situation warranted it, because the choice could to risk the legal trouble or watch them die. It is also much less expensive to keep a vial of epinephrine and a syringe (like the old fashioned allergy kits) but you must know the dosages to use. The problem is that in anaphylactic shock epinephrin will only be effective for about 15-20 minutes and than the reaction continues. You need to get medical help within that time frame, or have another option until you can get medical treatment, this may be a second dose of epinephrine or a longer acting antihistamine such as diphenhydramine (Benadryl). It is best to have it in an injectable form, but in a pinch can be given sublingualy. If I were not (or a family member) was not allergic I do not think I would bother to have anything more than some Benadryl on hand, as the risk of a problem is very low.

[Andrew Dewey]

So, for a non-allergic beekeeper... Morally right to have an epi pen?...no. Wrong not to have one?...no. Good to have?...yes Probability of needing to use it?....low. Could cause legal problems?...yes. Could save someone's life?...yes. Probability that it will expire before use?...high. Make you feel better to have one on hand?...maybe. Will you purchase one?...your decision.

Ed

Well Put!

[NCbeek]

I am an aspiring beekeeper, and a pollination ecologist. From all the literature I have read about bee venom if you are stung regularly (1+ times per month,) your odds of having a reaction are well under 1%. However, individuals who are stung infrequently (especially those who are stung only once per year,) may have a chance as high as 90% of going into shock over that time period. This is why beekeepers families are generally at the highest risk.

So, since I've only been stung 3 or 4 times in the past 3 years, the chances are pretty good I'll have a severe reaction this year. I really hope you are wrong but I would like to see the literature for myself if you have a link.

[StacieM]

Our family doc, who is also my 3-year-old son's pediatrician actually offered a prescription for an epi-pen for us to keep on hand when we told him I was beekeeping. I haven't been stung by a honeybee in 15 years, my husband is unsure if he has ever been stung, and my son has not ever been stung. We often have children here, and we do have one cousin who visits and IS allergic to bee stings (but carries his own epi pen). Our doctor gave us the epi-pen Junior, since there is a chance we would need it for a child. He wrote the rx in my son's name and our insurance covered it and our copy was $25. It came with two epi-pens (they are 1/2 adult strength) and a practice pen to use to make yourself comfortable with using it. I think the biggest concern where we live is the fact that we live in rural Kentucky and are at least 30 minutes to a hospital, and at least 25 minutes from the nearest ambulance (and I would be it would take twice that).

Statistically speaking, I hope we never use it. But, if someone goes in to anaphylaxis, I will be more than ready to use it, whether the rx was for them or not. If they want to sue me later for saving their life, so be it. I think the main thing to understand is that swelling, redness, and discomfort are NORMAL reactions to bee stings. You ONLY use an epi-pen for a true anaphylactic emergency.