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epipens?

16K views 56 replies 25 participants last post by  MaydayMalone 
#1 ·
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?
 
#3 ·
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/ency/article/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
 
#4 ·
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.
 
#5 ·
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.
 
#7 ·
<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
 
#6 ·
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
 
#8 ·
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.
 
#11 · (Edited)
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)
 
#12 ·
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.
 
#13 ·
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.
 
#15 ·
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.
 
#19 ·
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.
 
#16 ·
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/apiculture/pdfs/Marterre.2006a copy.pdf
http://www.cals.ncsu.edu/entomology/apiculture/pdfs/Marterre.2006b copy.pdf
 
#17 ·
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.
 
#20 ·
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.
 
#23 ·
We got an EpiPen years ago and it expired on the shelf. Recently we created our own story.

http://www.beesource.com/forums/sho...-boy-got-stung-went-to-ER&p=796452#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.
 
#25 ·
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.
 
#24 ·
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.
 
#26 ·
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).
 
#29 ·
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.
 
#32 ·
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"
 
#34 ·
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.
 
#35 ·
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
 
#36 ·
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.
 
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