Dilemma

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Justhikingthoughlife
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Joined: Mon May 05, 2008 4:40 pm

Dilemma

#1

Post by Justhikingthoughlife » Mon May 05, 2008 5:22 pm

Dilemma

So…you are out hiking with a bunch of people and someone gets stung by a bee. Within moments the person is having trouble breathing and other symptoms of anaphylactic shock are evident (I wasn’t actually trying to be poetic here I simply forget the other symptoms) As everyone turns to the victim asking where they keep their EpiPen the person looks at them with eyes wide with panic and says “I don’t carry one, I’ve never been stung before…I didn’t know I was allergic!” (Oh crap) what do you do?

My question is something the officers (those who are already certified that is) have been talking about for a while. While WFR’s are trained to use EpiPens can they actually legally obtain and carry them in case of extreme emergency?

We are in the process of reorganizing, regrouping and re-buying things for the clubs first aid kit. Now, the club hasn’t had one in years (and I mean years!) because anyone who comes with us comes at their own risk we are not held responsible for anyone as noone is technically a ‘guide’ and we are all ‘peer’ hikers. Because of this we aren’t required to have anything for anyone (so tough luck!) however since the majority are WFR a first aid kit has been deemed a necessity…after all peers or not if someone gets hurt the person with the most medical training would naturally step in and to protect their own interests they would rather have a first aid kit. Our logic was it’s one thing for someone who knows they are allergic to bees to bring an EpiPen and have someone (who knows how obviously) use it in the event that they can’t. But can we carry epinephrine in the kit in the event that someone who has never been stung before has a reaction?

There are tons of legal stuff surrounding this I am sure…but anyone know an answer?

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DaveK
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Re: Dilemma

#2

Post by DaveK » Mon May 05, 2008 9:56 pm

Justhikingthoughlife wrote:Dilemma

So…you are out hiking with a bunch of people and someone gets stung by a bee. Within moments the person is having trouble breathing and other symptoms of anaphylactic shock are evident (I wasn’t actually trying to be poetic here I simply forget the other symptoms) As everyone turns to the victim asking where they keep their EpiPen the person looks at them with eyes wide with panic and says “I don’t carry one, I’ve never been stung before…I didn’t know I was allergic!” (Oh crap) what do you do? At a minimum, carry an OTC medication like Benadryl. Benadryl is always in my kit and I always carry at least one epipen (and most times I have two). I have checked with my physician friends and they advise me that the epipen should be used in conjunction with benadryl. The epipen gives immediate relief and the benadryl gives more long lasting relief, but takes some time to work. There are, OF CCOURSE, certain instances where the epipen should not be administered and before you get one, you must be familiar with these precautions. Also, be aware that the epipen is sensitive to heat and needs to be replaced when it expires.

My question is something the officers (those who are already certified that is) have been talking about for a while. While WFR’s are trained to use EpiPens can they actually legally obtain and carry them in case of extreme emergency? Depends on if your doctor believes that you are in need of such a device. The medical opinion of the doctor controls.

We are in the process of reorganizing, regrouping and re-buying things for the clubs first aid kit. Now, the club hasn’t had one in years (and I mean years!) because anyone who comes with us comes at their own risk we are not held responsible for anyone as noone is technically a ‘guide’ and we are all ‘peer’ hikers. Because of this we aren’t required to have anything for anyone (so tough luck!) however since the majority are WFR a first aid kit has been deemed a necessity…after all peers or not if someone gets hurt the person with the most medical training would naturally step in and to protect their own interests they would rather have a first aid kit. Our logic was it’s one thing for someone who knows they are allergic to bees to bring an EpiPen and have someone (who knows how obviously) use it in the event that they can’t. But can we carry epinephrine in the kit in the event that someone who has never been stung before has a reaction? I think that there are more situations than bee stings that can cause the type of reaction for which the epipen is indicated. People with a history of severe allergic reactions to all type of insect stings, plant reactions, food allergies, and other reactions can all potentially require some form of immediate relief.

There are tons of legal stuff surrounding this I am sure…but anyone know an answer?
DaveK
K6DTK


Extremism in the defense of liberty is no vice.
Moderation in the pursuit of justice is no virtue.

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toms
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Re: Dilemma

#3

Post by toms » Tue May 06, 2008 11:36 pm

As a WFR you have 6 wilderness protocols that allow you to provide treatment beyond a normal EMT provided you are in wilderness context which is defined as 2 or more hours from definitive medical care. There is one excepting to the wilderness context and that is if some one is repertory distress as a WFR'er you can administer the epinephrine even if not in a wilderness context.
As a WFR're you need to be "certified" and "authorized". You get certified by passing the course. You must be authorized by a medical doctor. Normally if you work for an outdoor company you are authorized by the doctor signing off on the 6 wilderness protocols for the company which then applies to you as an employee.

Dave is correct, after administering the epinephrine you follow up with 50 mg of Benadryl (that is 2 25mg tablets). The Benadryl will provide a longer term benefit while you transport to the hospital. Anybody you give epinephrine to is going to the hospital. As a WFR'er you can give up to 3 doses of .3 mg epinephrine of a 1:1000 solution if the first ones do not have the desired effect.

The Good Samaritan act will protect you provided you do not practice outside your training and authorization and you do not take compensation. Accepting a beer afterwards could be construed as compensation!

I carry a vial of epinephrine, 3 syringes, alcohol packs, and Benadryl in a nalgeen bottle in side my first aid kit.

You can also use epinephrine for someone in respiratory “distress” due to asthma attack. However, do not give them any Benadryl.

If you have WFR’ers in the group, there should not be issues with giving the club purchased epi to someone in distress when following their training and protocols.
Tom Severin
KI6FHA
See you on the Trail!
TomS
KI6FHA / WPZW486

Badlands Off-Road
tom@4x4training.com
http://www.4x4training.com

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