How quick thinking and an EpiPen can save a life.
By Josh Piven
EMERGENCY SITUATION: Youíre hiking with your troop in a wilderness area, and a bee stings one of your Scouts. The Scout is highly allergic and goes into anaphylactic shock. What should you do?
SOLUTION: Anaphylaxis (severe, multisystem allergic reaction) can be a life-threatening medical emergency and should be treated as such. Assuming you have a mobile phone, immediately tell someone to call 911 and report the situation.
If youíre in the wilderness, however, help might take too long to arrive. So administer help yourself. Stay calm, as this will help you think clearly and give the victim confidence that assistance is on the way.
First, check the ABCs (airway, breathing, and circulation). Other symptoms develop almost immediately on exposure, and they could include abnormal breathing, weakness, hives, arrhythmia (abnormal heart rate), confusion, abdominal pain, light-headedness, and swelling of the throat.
Note that one, several, or all of the symptoms might be present. Skin rash or irritation alone, though, should not be considered life threatening and may be treated with an oral dose of antihistamine.
CPR should be started, if needed. Next, prepare an epinephrine injection. Individuals with severe insect-sting allergies must always carry a doctor-prescribed injection of epinephrine in the form of an EpiPen Auto Injector.
The adult leader responsible for prescription medicines on the trip should carry the EpiPen, and he or she should tell the other leaders where the EpiPen will be stored.
To use the injector, remove the yellow or green cap from the storage tube and remove the EpiPen. Then, hold the injector in your fist, black tip pointing straight down. With your other hand, pull off the gray ďsafety releaseĒ on the opposite end of the tube (donít remove it until youíre ready to give the injection).
The injection mustórepeat mustógo into the victimís outer thigh. No place else. Do not bother to remove the victimís pants; the EpiPen is designed to penetrate clothing. To administer the dose, hold the injector, black tip facing the leg, several inches from the outside of one thigh. Then, swing your arm and jab the thigh until the injector clicks. The injector should be at a 90-degree angle to the leg and go straight in.
Hold the injector against the thigh for 10 seconds while the epinephrine is injected. Some liquid may be left in the injector. But the small, clear window in the injector will show red when the proper dose of medication has been administered.
Remove the injector and massage the thigh for a few minutes. Finally, place the used injector back into the storage tube.
The symptoms should subside, and the victim should recover immediately. But watch for symptoms of shock, and keep the victim warm and comfortable.
Keep in mind that an EpiPen should never be removed from its case except to use, and the black tip holding the needle should not be touched.
Most people in anaphylaxis recover after the epinephrine injection. Still, monitor for changes and transport the person to a medical facility as soon as possible. Take the used EpiPen with you. If transporting the victim will take hours instead of minutes, itís recommended that the victim take an oral antihistamine like Benadryl, if the victim is able to swallow.
Josh Piven is the co-author of the Worst-Case Scenario Handbook series. Visit his Web site at joshpiven.net.