# do you keep an epi pen on hand for emergencies?



## cathleenc (Aug 16, 2007)

we just started our first hive a few weeks ago - successfully - and I called our family doc's office to request a prescription for an epi pen. Just to keep on hand in case anyone had an anaphalactic reaction to a bee sting.

Seemed like the responsible, common sense thing to do. We're rural and I can't imagine getting help here or getting to help in under 15 minutes at the very very best.

The dr's office said NO! and the nurse was very condescending about how 'MEDICINES ARE DANGEROUS IN UNTRAINED HANDS' (yes, she yelled at me).

Sooooo - do you have one? do you think an epi pen s hould be part of a beekeeper's kit? anything information or literature to back up my request to my doctor? should I just drop my efforts and hope all goes well?

I do not know that any immediate member of my family is allergic. I have 2 young sons - one of whom gets big reactions to some bites - but big reactions that stay localized in the affected limb.

What are the legal ramifications of having a bee hive - no epi pen - and a visitor who does have an anaphalactic reaction?

would love to hear your thoughts and strategies.
thanks
Cathy


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## Gailann Schrader (May 10, 2002)

Yes! I do!!! If someone visits and has a reaction? I have it. I have several friends that have severe allergies to bee stings.

My son has asthma so it was very easy to get for me.

However, I also have epiniphren (sp possibly) on hand for adverse reactions to vaccinations with goats. It's extremely easy to get in the Farm Stores. Look for it in the refrigerated section...

If I can remember to get my hands on the Epi-Pen, I'll get the mil amount for you.

Then just keep a small, sterile syringe and draw the epiniphren to give in an emergency if your doc won't let you be pre-armed.

I think he's being dense, as is the nurse.


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## Gailann Schrader (May 10, 2002)

I found this on Wikipedia (I LOVE Wiki!)

EpiPen is manufactured by DEY L.P. EpiPens are commonly carried by persons with severe allergies and a risk of anaphylactic shock because they can be self-administered and are very fast-acting. In the UK and US, EpiPens are regulated medical devices and require a prescription. In Canada, EpiPens may be purchased without a prescription, but they are kept behind pharmacy counters.

The standard dosage of epinephrine supplied by an EpiPen is 0.3 ml of 1 in 1000 Parts (0.3 mg). Child-sized dosages (0.15 mg) are available as the EpiPen JR. In the US, EpiPen JR is recommended for children 33-66 lb.[1], while in Canada it is recommended for children 15 to 30kg. [2]

The EpiPen contains a spring-loaded needle that shoots through a membrane in the tip and into the recipient's body to deliver the medication.

EpiPen usually has a shelf life of 20 months, when the EpiPen should be discarded if unused, by returning it to a local pharmacy or hospital for safe disposal. Using an EpiPen that has expired is discouraged but better than nothing in an emergency.

The original carrying tube that the pen came in was easily broken; however, the manufacturer has recently begun shipping EpiPens in more durable carrying tubes with significantly thicker plastic walls, a screw top, and metal plating at the bottom (needle) end to prevent puncture injuries.

Despite being trademarked, common usage of the word "epipen" is drifting toward the generic context of any epinephrine autoinjector.

**I believe an insulin syringe would work well. It's not a spring loaded thing like an epi-pen? But it's better than dead.


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## alleyyooper (Apr 22, 2005)

Yes we carry one each in our kit for JUST in case. We did not ask our doctor for one. She just automatiac wrote the scrip for it when she found out we were keeping bees. She also has her recestption(s/p) call us to come in and pick up the new script when the pens are about to expire (about every two years). She explained that you really need two just for the one person that gets stung.
We also have huge (18"x24") private property no tresspassing signs on both sides of our driveway just as you turn off the road. We have them to inform people they are entering at their own risk.
It is the only bee yard we have close to the driveway and close to our house.

We bought bee colonies from a fellow last summer who had been keeping bees for 47 years. He got stung just once while working them and had a horriable reaction. He was able to get EMS to his location in time to save his life but still spent 4 days in the hospital. He should have had an epi pen on hand. His doctor now gives him a scrip for two just for his self.

As for your doctor I would just march in the office and demand my records as I will not allow some desk bound person to yell at me over a simple request. A simple NO and an explaintion why not is enough.
I would then look for a doctor who took my working with bees as a possiable future problem and for arm me. 

 Al


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## Mike in Ohio (Oct 29, 2002)

Nope,

If you have visitors and a bee stings them it is no different liability than if the hives were on the next property. Bees are not considered livestock. If you administer first aid and you are not trained and certified in first aid (administering aid with an epi-pen is NOT covered by Red Cross first aid courses) then you DO incur liability. From a liability perspective you are better off not attempting to administer an epi pen to someone. 

You should always ask any guests if they are allergic to bee stings and if the answer is yes then don't bring them near your hives. This is called being courteous and using common sense.

Mike


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## Gailann Schrader (May 10, 2002)

That actually surprises me. The Good Samaritan law I had believed covered these kinds of things. 

For myself? I'd rather run the risk of trying to save someone's life than watching them die. We have become such a litigious society....


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## Mike in Ohio (Oct 29, 2002)

Gailann Schrader said:


> That actually surprises me. The Good Samaritan law I had believed covered these kinds of things.
> 
> For myself? I'd rather run the risk of trying to save someone's life than watching them die. We have become such a litigious society....


Good Samaritan laws protect trained individuals who help, not the average person who helps. These laws only protect the individual to the extent that they are rendering service within the scope of their training and in basic accordance with that training. The idea being that they shouldn't be liable civilly for acting in a capacity that they are trained and certified.

I have had various Red Cross certifications through work for a number of years (CPR/AED, First Aid) and part of what they cover in the training is Good Samaritan laws. Current training at this level is basically to stabilize an individual until 911 first responders arrive - nothing more. To go beyond that you would need to have basic EMT training/certification.

Apart from the training requirement, if an individual refuses assistance and you attempt to provide it you are not protected by Good Samaritan laws - this falls under the informed consent requirement. If a person is unconscious or is unable to give consent then in many jurisdictions (but not all) there is a presumption of consent.


Wikipedia has a pretty good write-up: http://en.wikipedia.org/wiki/Good_samaritan_law

With regard to bee stings, the best thing you can do is to avoid bringing at risk individuals near an active beeyard.

To those who carry an epi-pen for emergencies, how long have you carried one and how many times have you used it? For the vast majority of people the risk is miniscual. For those people who are at risk, the vast majority are aware and you only need ask.

Mike


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## Beltane (Nov 27, 2005)

I had not thought about keeping one around before you mentioned it. There is a great chapter in _The Hive and the Honey Bee_ if anyone can get their hands on a copy to read it.


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## madness (Dec 6, 2006)

I hadn't thought about it either. Hmmm....


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## notenoughtime (Aug 13, 2007)

Cathleenc, I would like to comment on the nurse that "yelled at you". Although I have let my nursing license laps, (I was a nurse for 18 yrs) she really over step her bounds by telling you that. It is up to the doc to decide and if it was my docs office I think I would contact them and tell the office manager what happened or if you can tell the doc. Also the nurse should understand that even though you have never had a reaction to a bee sting inthe past it can happen at any time. (allergic reactions to medications can also happen even if you have taken it before also). And when you work with thousands of little critters it would be comforting to know you do have a pen handy. Now to the epi pen, I don't have one either yet but I do ask people that will be close to the hives if they are allergic. Will put that one the list of things to get. Thanks for the reminder.


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## cathleenc (Aug 16, 2007)

notenoughtime said:


> Cathleenc, I would like to comment on the nurse that "yelled at you". Although I have let my nursing license laps, (I was a nurse for 18 yrs) she really over step her bounds by telling you that. It is up to the doc to decide and if it was my docs office I think I would contact them and tell the office manager what happened or if you can tell the doc. Also the nurse should understand that even though you have never had a reaction to a bee sting inthe past it can happen at any time. (allergic reactions to medications can also happen even if you have taken it before also). And when you work with thousands of little critters it would be comforting to know you do have a pen handy. Now to the epi pen, I don't have one either yet but I do ask people that will be close to the hives if they are allergic. Will put that one the list of things to get. Thanks for the reminder.


I will talk to the doctor myself - we have a very good raport and I've brought up lots of things/challenges along the way so this will fit right in.

I was swarmed by wasps as a child and had so many 'local' reactions that my eyes and ears swelled shut and could not bend arm nor leg nor finger for about 4 days. Over 200 stings. It really was just local reactions but so many locales! I guess the thought of not having an epi pen gives me great anxiety and sheesh, doesn't that alone qualify it as a needed medical device? lol. 

Our doctor responds wonderfully to outside literature - things in writing - reference material. If anyone knows of anything of the sort recommending an epi pen as standard farm first aid or beekeeping kit could you please point me in the right direction?


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## Gailann Schrader (May 10, 2002)

Thanks, Mike! I LOVE Wikipedia!!!

It used to take ages to research things... Now with the internet? Seconds. 

Thanks again!


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## Durandal (Aug 19, 2007)

We have an adult and a child on hand at all times on our farm. We have 300 acres, a 32 horse boarding operation and have folks visit us all the time. We carry insurance, lots of it.

Better to have it an not need it than need it an not have it. Boy Scouts, the Army, and average U.S. Citizen's need to sue has taught me that. 

I was out on a swarm call one time, it was an urban setting about 10 miles from the farm. Here I am with a lit smoker, covered head to tail in a bee suit because it was raining and the cluster had tightened up and the couple wanted the bees off their property ASAP.

So I dug into them, which started them flying rain or not. I got a couple stings on my gloves so I was using the smoke really heavy to mask my gloves and along come these two kids, not even paying attention. I am maybe 12" from the main sidewalk.

Simply saying keep allergic people away is impossible.

Always be prepared and the curve balls life throws at you might be less painful.


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## marinemomtatt (Oct 8, 2006)

My mom is allergic to bee stings so she makes sure to have her epi with her when she comes to visit....my husband and I have Osha Root Tincture (quiets the histamine receptors) in our equipment box just in case we develope sting issues.


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## flannelberry (Jul 14, 2005)

I'm going to step in and say that epi is great but you need to be careful about relying overly on it. If you administer epi after a confirmed anaphylactic reaction you need to follow it up with Benadryl. Epi is extremely short acting and only useful to halt the emergency. It's the Bendaryl that is truly life saving - the epi buys time for the Benadryl to interfere with the anaphylactic reaction. Epi by itself doesnât not last as long as the venom.

Don't buy the tabs either - children's meltaways/chewables are the ones to use so the person reacting doesn't have to swallow anything big.

That alone may have been part of the nurse's reaction. There are people who have died of anaphylaxis because they used their epi pen and went about their day. Also, while epi isn't really a danger to people who are healthy, if you have any heart condition - diagnosed or not - you could put yourself at risk of a heart attack.

Just to add another perspective - only 1-2% of the Canadian population is at risk of any anaphylaxis. And iirc, bee venom and wasp venom are different - allergy to wasps doesn't translate to allergy to bees. Further, it's frequent stinging by bees that [generally] sensitizes people. Non-bee keeping (or not living near bee keeping) folks are generally not at risk from bees. Wasps however are a different story - a single sting from a wasp can sensitize you.

I also wanted to say â if you want to be listened to, make an appointment with your doc to discuss your concerns and reasons. Donât try to argue based on a webpage or internet finding â thereâs nothing that will shut them down faster. You can find just about anything on line! But do go in and discuss it. If not with your doc then a pharmacist. 

Here's an article from the BMJ that spells it out.

http://www.bmj.com/cgi/content/full/316/7141/1365


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## sugarbush (Jul 15, 2007)

I keep one on hand for myself..... I think they are a must have for every beekeeper.


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## Beaners (Feb 23, 2005)

Regarding the Good Samaritan Laws, I have to be certified as a professional rescuer and have other certifications and if it was my family or friend on the line, I would still give the epi. Even if I am not "covered" because I take that action. I would only do this in a personal situation though.

If I am participating in an activity that requires my professional rescuer certification, say at a practice or competition, or running a park program, I can't take action. Release forms may list me as the temporary guardian when a parent cannot be reached, and I may be able to authorize medical treatment, but I can't administer it myself.

I would be surprised by the behavior of the nurse, but we have a rotten one at our family doctor too.

Kayleigh


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## GoddessKristie (Jun 18, 2007)

I am so glad to see this thread! I had the same thoughts when we first began considering bees. You're right, it seems like the logical thing to have on hand. My intention is to put our bees in the center at the back of my property which is very far from neighbors, but with cousins and nieces/nephews over you never know. Also, it's hard to know if your own children are allergic if they've never been stung! I had planned to make an appt with my Ped when I get the bees to request and Epipen. I agree with the PPs who said the nurse probably wasn't the right person to talk to. I know that my Ped would be conscerned for my DS's health and would want me to have one just in case. I would also ask them to teach me how to use it and exactly what needs to be done and what to expect from the sting on.


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## cathleenc (Aug 16, 2007)

flannelberry said:


> I'm going to step in and say that epi is great but you need to be careful about relying overly on it. If you administer epi after a confirmed anaphylactic reaction you need to follow it up with Benadryl. Epi is extremely short acting and only useful to halt the emergency. It's the Bendaryl that is truly life saving - the epi buys time for the Benadryl to interfere with the anaphylactic reaction. Epi by itself doesnât not last as long as the venom.
> 
> Don't buy the tabs either - children's meltaways/chewables are the ones to use so the person reacting doesn't have to swallow anything big.
> Here's an article from the BMJ that spells it out.
> ...


thank you for your response and the link to the article - if I'm reading it correctly, the article does not even mention epi pens at all as part of the response. Sure does seem to say that having benedryl on hand is key and something I can take care of immediately.


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## alleyyooper (Apr 22, 2005)

We also carry Benidril. Kare still swells baddly and it last several days when she is stung. We found the sooner she can get the Benidril working the swelling seems to go away sooner and isn't so bad.

:angel: I keep telling her that she just needs a sting a day for about 10 days and her swelling will stop altogether. Sue Hubble recommends a sting a day for 30 days in her book.
Well Kare won't have any thing to do with it even thought she has seen it work for me.

 Al


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## sugarbush (Jul 15, 2007)

cathleenc said:


> thank you for your response and the link to the article - if I'm reading it correctly, the article does not even mention epi pens at all as part of the response.


Actually it does.....epinephrine falls under intramuscular antihistamines.... I think the reason they speak of benidryl by name is that it is available over the counter so most people have it available in their medicine cabinet. Epi-pens are perscription only and most people don't just have one on hand.....they also only have a shelf life of 6 months so if you did just have one on hand and it wasn't new it would be useless.


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## indypartridge (Oct 26, 2004)

I have been told that as an alternative to an EpiPen one can easily pick up generic, nonprescription epinephrine inhalers (e.g., "store brand" Primatene Mist). 

I'd be interested in comments from knowledgeable folks about whether this is reasonable or not.


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## alleyyooper (Apr 22, 2005)

Our epi pens have an expireation date of 20 months.

 Al


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## jayzee (Mar 9, 2008)

flannelberry said:


> I'm going to step in and say that epi is great but you need to be careful about relying overly on it. If you administer epi after a confirmed anaphylactic reaction you need to follow it up with Benadryl. Epi is extremely short acting and only useful to halt the emergency. It's the Bendaryl that is truly life saving - the epi buys time for the Benadryl to interfere with the anaphylactic reaction. Epi by itself doesnât not last as long as the venom.


I have 2 kids with food allergies, and I have to carry epi-pens for both of them. What we have been told by the doctor (and what all the newsletters from the food allergy/anaphylaxis organizations say) is that if you give an epi shot, you must go immediately to the hospital. If it takes more than 30 minutes to get there, you have to have the 2nd shot on hand and ready to give as well. They are now saying that Benadryl is not the way to go as the 2nd medication - I'm not completely clear on why, but that is what I have been reading lately. The part about going to the hospital was standard before they changed the Benadryl recommendation though.

Jen


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## jayzee (Mar 9, 2008)

indypartridge said:


> I have been told that as an alternative to an EpiPen one can easily pick up generic, nonprescription epinephrine inhalers (e.g., "store brand" Primatene Mist).
> 
> I'd be interested in comments from knowledgeable folks about whether this is reasonable or not.


My understanding is that the OTC inhaler is not a good substitute. The epi shot works a lot faster and you know what dosage you are getting, while the other is more difficult to get in (especially if you are dealing with anaphylaxis and the lungs are closing up - kind of difficult to inhale a medicine adequately at that point). I wouldn't mess around with it - if epinephrine is needed, I would make sure it is via a shot.

Jen


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