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comment by b_b
b_b  ·  3018 days ago  ·  link  ·    ·  parent  ·  post: Seattle's $20 Epipen replacement

But seriously, how difficult is delivering a shot? You could learn it in five minutes. Epipen price is now reflective of regulatory arbitrage than any thing else. If I were in a situation where my life was in danger, if wouldn't care if a "basic" EMT administered my medicine.





Devac  ·  3018 days ago  ·  link  ·  

    But seriously, how difficult is delivering a shot?

Source: my mother, recently retired medical doctor. You guys got a "Hello" from her by the way. Feel free to ask follow-up questions, just keep in mind standard disclaimer that this is not in any way a medical advice, just fact checking.

Intramuscular injections that are recommended for adrenaline/epinephrine in case of shock are up there among the easiest ways for untrained person to break needle. It's not common, but happens mainly due to lack of experience. Neither of us knows precisely what are the competences of 'basic EMT' in USA, but through know-how on IM injections is a must. Panicked person who probably does it for the first time in a life-threatening situation is much more likely to mess up than fairly used to it nurse or EMT.

Main problem with needle breakage is the fact that it can be brushed off as pronounced after-effects of condition that required fast administration of medications (seizure, anaphylactic shock). Muscle pain, general discomfort, muscle spasms or cramps (EDIT: and in case of anaphylaxis it can even potentially not show a typical immune response for foreign object) that often occurs after such situation can 'hide' the pain caused by needle tip in some cases. We don't know how it looks in USA, but in Polish hospitals it's among reasons why many routine procedures are done in pairs. For example one nurse preps the patient, the other prepares and makes an injection and in the end you have two sets of eyes capable of catching errors. In this case: procedural errors and results like the mentioned needle breakage.

_thoracic  ·  3018 days ago  ·  link  ·  

Devac, b_b, you're both right. Prepping an IM Epi injection isn't super difficult, and some AlS(AEMT and paramedic)providers I know say basics should already have it. Five minutes to mastery is low-balling it though.

Where the difficulty would likely arise is in training a state's worth of basics on a new skill that involves sharps and one of the more powerful meds we keep on the truck. Given the potential complications like Devac mentioned, you want to be well practiced at it. Lots of my state is covered by volunteer EMS services that don't get a ton of calls, and even fewer anaphylaxis calls. Staying sharp with your sharps can be a little difficult in that kind of situation, but it will probably be ultimately doable.

_thoracic  ·  3018 days ago  ·  link  ·  
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