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Thread: epipens?

  1. #21
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    Default Re: epipens?

    Quote Originally Posted by Verick369 View Post
    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.
    While it's true that frequent stings (daily to monthly) generally desensitize, I haven't seen a figure anywhere close to 90% chance of allergy for infrequent stings. The highest allergy incidence I have seen in the literature is around 17% (among beekeepers stung infrequently) - can you point me to a reference for your higher number?

  2. #22
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    Default Re: epipens?

    For what it's worth, I asked my kids' pediatrician (also a beekeeper) whether I should have one on hand just in case someone is allergic. He thought it was completely unnecessary and refused to write a script for it.

  3. #23
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    Default Re: epipens?

    We got an EpiPen years ago and it expired on the shelf. Recently we created our own story.

    http://www.beesource.com/forums/show...452#post796452

    My son doesn't want me to get rid of the hives.

    Use an EpiPen and you get a mandatory trip to the ER. Benadryl may be enough to do the job.

    Hand someone an aspirin and you're on the hook. Let them have at the first aid kit and it's on them. Make your choice, pay up and take your chances.

  4. #24
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    Default Re: epipens?

    I will need to figure out what book it was. My professor had what we called "the bee bible," and it was a few thousand pages and was cited to scientific papers all the way through. The first sting of the season will always be the worst and is always the one you should keep an eye on. If I can get him to bring in the book again I will find the research paper and share it. After reading it my philosophy is get stung once a month or not at all though.

  5. #25
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    Default Re: epipens?

    Quote Originally Posted by throrope View Post
    We got an EpiPen years ago and it expired on the shelf. Recently we created our own story.

    http://www.beesource.com/forums/show...452#post796452

    My son doesn't want me to get rid of the hives.

    Use an EpiPen and you get a mandatory trip to the ER. Benadryl may be enough to do the job.

    Hand someone an aspirin and you're on the hook. Let them have at the first aid kit and it's on them. Make your choice, pay up and take your chances.
    Benadryl may be enough for a typical reaction, and after reading your son's story, it doesn't sound like true anaphylaxis, which would result in blood pressure bottoming out. Or maybe it was, and was already being counter-acted by the Benadryl and steroids? A lot of people have goofy reaction to bites and stings, and some of those even include some degree of swelling of the mouth or throat (which don't get me wrong, is SERIOUS). But a true anaphylactic emergency is a systemic reaction (meaning a sting on the toe could cause the throat to swell).

    The fact of the matter is, I don't think I would offer a person suffering a true anaphylactic emergency benadryl to prevent getting sued from giving them an epi-pen, and I wouldn't force them to administer the epi-pen themselves. Even if you DID use the epi-pen on them, I believe you would be covered (legally) by the Good Samaritan laws.

  6. #26
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    Default Re: epipens?

    Quote Originally Posted by Verick369 View Post
    I will need to figure out what book it was. My professor had what we called "the bee bible," and it was a few thousand pages and was cited to scientific papers all the way through. The first sting of the season will always be the worst and is always the one you should keep an eye on. If I can get him to bring in the book again I will find the research paper and share it. After reading it my philosophy is get stung once a month or not at all though.
    I would love to know the validity of the claim the author made. Allergies are tricky. You have to have been exposed to an allergen to form an allergy. Other than that, it is generally a crapshoot. You can be stung by bees every year for twenty years, and there is no rhyme or reason as to what triggers your body to form an allergic response (basically an over reaction by your immune system). I do think there are some risk factors though (like having asthma, which is also an immune system over reaction and is something that I do suffer from).

  7. #27
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    Default Re: epipens?

    Quote Originally Posted by StacieM View Post
    Even if you DID use the epi-pen on them, I believe you would be covered (legally) by the Good Samaritan laws.
    You would not be covered by good samaritan laws for administering an epi pen to someone unless a) it is their prescription; b) you are a trained medical professional; and (I think) c) an EMT. Getting fuzzy on that last one, an EMT may need direction from a doctor or nurse, not sure.

  8. #28
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    Default Re: epipens?

    Quote Originally Posted by Irmo View Post
    You would not be covered by good samaritan laws for administering an epi pen to someone unless a) it is their prescription; b) you are a trained medical professional; and (I think) c) an EMT. Getting fuzzy on that last one, an EMT may need direction from a doctor or nurse, not sure.
    I disagree. From my understanding most states allow lay persons to administer epinephrine, just like CPR, and it is protected under Good Samaritan laws. Only a few states have specific laws requiring training and/or certification to use an epi-pen. In other countries (Canada I believe), epinephrine doesn't even require a prescription to get.

  9. #29
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    Default Re: epipens?

    True on Canada, and you can administer epinephrine as a lay person if it has been prescribed for that person. In other words you can help them with thier pen in the event they are incapacitated by the shock. You can't give it to someone it wasn't prescribed for.

  10. #30
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    Default Re: epipens?

    The book was "The Hive and the Honey Bee." Link below. I know it is dated but they only release a copy ever 10 or so years and this is the latest version to the best of my knowledge.

    http://www.amazon.com/Hive-Honey-Bee...adant+%26+Sons

  11. #31
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    Default Re: epipens?

    Quote Originally Posted by StacieM View Post
    I would love to know the validity of the claim the author made. Allergies are tricky. You have to have been exposed to an allergen to form an allergy. Other than that, it is generally a crapshoot. You can be stung by bees every year for twenty years, and there is no rhyme or reason as to what triggers your body to form an allergic response (basically an over reaction by your immune system). I do think there are some risk factors though (like having asthma, which is also an immune system over reaction and is something that I do suffer from).
    It's not quite a crapshoot, but immune responses are complex and potentially chaotic over longer timescales. An allergic response requires high levels of IgE antibodies and low levels of IgG antibodies.

    IgE antibodies are reactive. They appear following exposure to a foreign protein (such as on a virus or bee venom) and can multiply rapidly to high levels, ready to mount a full-scale attack the next time the protein appears. We have these antibodies to thank for the fact that getting the flu makes us immune to that particular flu strain. Unfortunately a bee injects millions of proteins directly into the bloodstream, potentially triggering a response so large that it is life-threatening.
    IgE levels are stochastic, a "crapshoot" if you will. IgE may spike after the first sting, the 501st sting, or never in a lifetime of stings. Certain factors (such as other allergies) can tip the odds, but there is always some probability of an IgE response.

    IgG antibodies are suppressive. They build up over time following regular exposure to particular proteins and inform the body that an immune response is unnecessary. In some cases IgG antibodies even bind to and inactivate IgE antibodies. Beekeepers who are stung more often have more IgGs in their blood. Desensitization (allergy shots) works by building up IgG levels to balance out IgE levels. IgG levels drop if exposure is not maintained; hence the common report that the first stings of spring are the strongest.

    The upshot is that it is best to be stung often or not at all. I'm in the "often" camp because:
    a) "not at all" is difficult to achieve as a beekeeper
    b) exposure to residual venom (on clothes, in the air) can trigger allergy in the absence of actual stings.
    c) I had an allergic response (high IgE levels) so want to keep my IgG titer high.
    d) I swell a lot less after my 75th sting than after my first few.
    e) My friends think it's badass that I intentionally sting myself every week.

    Mark

  12. #32
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    Default Re: epipens?

    Every state has their own laws... but in this case I think most states would be the same as Mississippi. I was a certified EMT before, and this question is ALWAYS asked in training. Answer: It is AGAINST THE LAW for you to administer any medication to a patient if you are not Paramedic certified/ licensed practitioner/ or medical doctor.... it will not be covered by good samaritan laws... and even if the patient does not sue you, the state still may. IF you do keep an Epi-pen as a beekeeper... you can let someone administer it to themself if they think they are having an allergic reaction... and you may assist them to administer it... just do not forget "It is AGAINST THE LAW for you to administer any medication to a patient if you are not Paramedic certified/ licensed practitioner/ or medical doctor.... it will not be covered by good samaritan laws... and even if the patient does not sue you, the state still may"

  13. #33
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    Default Re: epipens?

    I was perscribed 1 after I mowed a little to close to a flowering tree last year that was covered in bees. I was stung several times before I made it to the house. I did have a reaction, due to the many stings, so I was given 1 incase of another reaction.

  14. #34
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    Default Re: epipens?

    it will not be covered by good samaritan laws... and even if the patient does not sue you, the state still may
    Nobody is going to sue you unless someone comes to harm, and the risk of harm from epi-pens is quite small (though admittedly not nonexistent). That said, if you do have an epi-pen and intend to use it on others if necessary, it would be a good idea to have a conversation about it ahead of time with anyone who visits the bee yard. Something along the lines of "Severe bee allergy is very very rare, but should it happen to you I have an epinephrine injector which can keep you alive until the ambulance arrives. If you experience any difficulty breathing or lightheadedness following a sting, let me know ASAP."

    If someone has a reaction, the best course of action is probably to call 911 immediately (if you have phone service), get an ambulance on the way, and get the 911 operator's approval to use the pen (which should absolve you of some legal responsibility). But if the reaction progresses rapidly I would not hesitate to use it.

    The legally-motivated suggestions to have the patient administer the pen themselves strike me as foolish from a practical perspective. By all means invite them to do so, but if they have never practiced with an epi-pen before, and they're feeling like their own body is about to kill them, having an experienced, steady-handed bystander do the actual injecting makes far more sense to me. Should I ever find myself in that situation, well, let's just say I'll worry about the law later.

  15. #35
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    Default Re: epipens?

    You can do anything you want... maybe you will be right, and then again maybe you weren't right to administer a controlled drug to someone without training or knowledge of their history... It is not just a simple matter by any means. Then after the fact no matter if you were right or wrong... when you ANSWER the question to a person with a uniform on... "Did you inject this patient with this epi-pen?" When you begin your answer with "Well, I thought xxxxxxxxx" THEN you will understand what I am talking about. I would not inject anyone that was not immediate family to me and I was TRAINED to do it. There are other medical conditions that may exist that cause a person to die if you give them that epi-pen... then again maybe it wasn't anaphylactic shock they were having when you decided to stick them. Then again... maybe they were unconcious and you decide to stick them... then they die. ??? HOW Will you answer the police when THAT is brought to light?
    I am just another beek here... so dont take my word for it... call a doctor and discuss it with them and see what they say. Ask them if it would be a good idea to keep an epi-pen just in case someone in your apiary seems to have an alergic reaction to a bee sting. Good intentions dont mean as much as you might think it does... unless you are doing what you have been trained to do AND did it in a professional manner and to the standards of your own training. I know EMT/ Paramedics who have defended themselves with good samaritan laws. Had they done anything out of their training or to a level that was not consistent with their training.... they would have gone to jail.... the affect it had on the patient good/ bad... would have been irrelevant.
    Nuff' said by me.... but if you decide you will stick someone... you should not be encouraging it here IMHO.
    Oh.. almost forgot... no 911 operator will EVER tell you to administer an injectable controlled drug to a person it was not prescribed to, and you not being trained to administer it in the first place.... without a qualified medical authority directing this action. FWIW

  16. #36
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    Default Re: epipens?

    Just buy an epi-pen. If you are concerned at all, spend the money and buy one. Don't worry about other people and all that jazz. Buy one, take it with you, use it if you need it. My doc was a little bit confused when I asked for one and told her I wasn't allergic. I told her that I was worried that with all the stings, I may have a bad day at some point and want to be prepared. She was fine with writing the script. I feel better knowing that I have it if I need it, not just for bee stings. Even if it's $200 a year... it's a small price to pay to feel comfortable.

    If you really want to get into the deal about sticking another person, just call 911 and ask them if you should use it.

  17. #37
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    Default Re: epipens?

    Well said DamSutt.

    I should probably let this slide, but Sippy sure has an inflammatory writing style...

    Sting-induced anaphylaxis is not difficult to diagnose. Any combination of full-body itching, difficulty breathing, lightheadedness etc. that comes on immediately after a bee sting will 99% of the time be an allergic reaction to the sting. Of course I'm not randomly going to stick someone. My point was only that in true anaphylaxis, having a second person on hand to do the actual injecting is a good thing. Think about it. As evidenced by many folks on this board, anyone can walk into a doctor's office, say they have bees and are worried about allergy, and walk out with an epi-pen prescription. There is no training provided or required.

    Should you use a pen on someone else (with their permission of course), the appropriate question is not "is it legal?" but rather "would a trained doctor in my place have made the same decision?" If the answer to the latter is yes, there should be little to worry about. Of course the best option is to get a trained doctor on the phone, but if that isn't possible your judgment, and that of the person experiencing the reaction, are all that you have to go on.

  18. #38
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    Default Re: epipens?

    Quote Originally Posted by Irmo View Post
    You would not be covered by good samaritan laws for administering an epi pen to someone unless a) it is their prescription; b) you are a trained medical professional; and (I think) c) an EMT. Getting fuzzy on that last one, an EMT may need direction from a doctor or nurse, not sure.
    FWIW, I am an EMT licensed in AL and in VA. I may ASSIST a pt in adninistering an epi-pen to themselves but ONLY after checking to ensure that 1) that pen was prescribed to THAT pt and to no one else and, 2) that the pen is in date. I cannot administer it myself but can only ASSIST. An Advanced EMT or Paramedic may administer but only per protocol - either standing orders or after receiving verbal orders from the medical control officer. Any other situation is dispensing a prescription drug illegally and is, I believe, a federal offense. It is, at least, a violation of law in every state of which I am aware. And yes, you CAN be sued. And yes, if you've been found to be dispensing drugs without a license you will be charged with such.

    My opinion is that anyone who gets a prescription from their doctor for an epipen so that it can be on hand in CASE another person has an anaphylactic reaction has likely misrepresented their intentions to the doctor.

    If you're really worried about this, keep some Benadryl on hand and a cell phone to call 911.

    -js

  19. #39
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    Default Re: epipens?

    I sincerely apologize if you take my words to be inflammatory... I really do not want to offend anyone... but I was trained as an EMT... and I know what is specifically stated in my training.... It might not seem to be so serious here in this forum... but in my training it was treated very seriously.
    Again... I do not suggest administering drugs to other people without real training... But i also apologize if saying this is offensive to you.

  20. #40
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    Default Re: epipens?

    I buy a new set of pens every year. I am no more allergic to bee venom as most of the population, but bee yard events do happen. I dropped a deep while doing a reversal a couple of years ago. I was stung more times than I could count. I did not go into anaphylaxis. I did have a systemic reaction with hives covering every inch of my body. I had no problems breathing. I took a double dose of children's Benadryl, gave the epi-pen to one of my kids and waited to see what might transpire. In about 30 minutes, the symptoms dissipated and I was able to head back to the yard (with full bee suit this time) to put the hive back together.

    While not needed, I'm glad that the pen was handy. I show my wife and kids how to use the pen when the prescription is renewed.

    As to using MY pen on somebody else... While the legal ramifications could be devastating, if somebody was in the throes of anaphylaxis, I would probably use the pen. I hope that I never end up having to make that decision.
    -Phil Domeier
    www.nowthenhoney.com

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