Re: [Philmont]: Peanuts, EpiPens, and Anaphylaxis

As a pharmacist, I think I can add a little to this.

Unless prescribed to you, you cannot just go out and purchase an EpiPen. It
is illegal (federal offense) for you to even have an EpiPen on your person
if not prescribed to you. That being said, I know of no law enforcement
agency that would check or bust a Scout leader for carrying an EpiPen for
someone under his/her care.

The statement about EpiPen without Benadryl may need some clarification.
Epinephrine (active ingredient in EpiPen) is the only administrable drug
that will halt the process of anaphylaxis. Benadryl (and other first
generation antihistamines) will lessen the symptoms of the allergic
reaction, but antihistamines should be taken only in addition to epinephrine
for the treatment of anaphylaxis and should not be considered a substitute
for it. Second generation antihistamines (Allegra, Claritin, Clarinex) are
a bit less useful than first generation antihistamines such as Benadryl
(diphenhydramine) or Atarax (hydroxyzine). Zyrtec, considered a 2nd gen AH,
is really the first metabolite of hydroxyzine, and has better effect than
other 2nd gen AH.

If anyone in your crew uses orally inhaled STEROIDS (not Ventolin or any
other rescue inhaler!), the orally inhaled steroid can also be an option for
secondary treatment of anaphylaxis (not telling you to take someone else's
meds, but desperate times may call for desperate measures). You MUST still
use the EpiPen first.

The main things I would stress it to make sure that the allergic participant
and the lead advisor BOTH have BRAND NEW EpiPens for the trip to Philmont,
and BOTH know how to administer the shot. Carry a supply of Benadryl caps
(available as 25mg caps over-the-counter). I cannot tell you how much to
give an anaphylactic patient, although I can tell you the maximum daily dose
of diphenydramine is 400mg. If I were there, I'd probably give 100mg to
150mg immediately, then give another 50mg every 3 to 4 hours until help
arrived or until the reaction is known to be under control. One of you
physicians out there may want to give better stat dose information.
REMEMBER IN MOST PEOPLE BENADRYL CAUSES DROWSINESS.

Also, educate yourself and the crew on anaphylaxis if you have a severely
allergic participant in the crew. Talk to an allergist, ER doc, or other
physician. There are many online sources of information, some better than
others. A couple are:

EpiPen's website - www.anaphylaxis.com
American Academy of Allergy, Asthma, and Immunology - www.aaaai.org

While on the medication subject, don't forget asthmatics. My brother
staffed at Philmont in the 80's and was totally helpless watching a young
man die because his inhalers were empty and help could not get there fast
enough from base camp. On our big trips, Philmont or otherwise, we do not
allow asthmatics to attend unless they bring 2 BRAND NEW inhalers of each
type used and show to the lead advisor before departing. One of each stays
with the participant. The other is given to the advisor that will be
working directly with the participant just in case.

Hopefully one of the physicians out there on the list will add clarity to my
information.

Shane Hoffman
Advisor Crew 445 - www.crew445.org - SHoffman@crew445.org
ASM Troop 445 - www.troop445.org - SHoffman@troop445.org
"We should all realize that every right implies a responsibility, every
opportunity an obligation, every position a duty, and that the most
effective sermon is expressed in deeds instead of words." ~ Waite Phillips

----- Original Message -----
From: "James H. Moss" <bsa.rec.law@gmail.com>
To: "Multiple recipients of list philmont" <philmont@troop47.com>
Sent: Thursday, December 01, 2005 1:00 PM
Subject: RE: [Philmont]: Peanuts

>I would strongly urge you not to buy epi pens! Have the child (parent)
> purchase the pens in the child's name. They require a prescription and
> administering a regulated prescription drug to someone whose name is not
> on
> the prescription is a crime. I've been researching this issue for 18
> months
> and just gave a presentation to the Wilderness Medical Society on it this
> summer.
>
> Maybe not a big thing, but you never know. But administering (possessing)
> a
> prescription drug with your name on it to someone else is a crime in every
> state.
>
> Also, epi without benadryl is worthless. You can't carry enough epi to
> solve the problem, it just buys you time. Benadryl is what will eventually
> solve the problem, if it is solvable outside an ER.
>
> Jim
>
> James H. Moss, JD, Editor
> Outdoor Recreation & Fitness Law Review:
> http://www.snewsnet.com/cgi-bin/snews/law_review/index.html
> The Outdoor Recreation & Fitness Law Reviews are publications for members
> of
>
> the Outdoor Recreation, Adventure Travel, Hospitality and Fitness
> Industry.
> For more information email me at: lawreview@snewsnet.com
>
> Outdoor Law Specific Email: outdoor.law@gmail.com
> Fitness Law Specific Email: fitness.law@gmail.com
>
> Instructor: Ski Area Operations, Ski Area Risk Management Course Colorado
> Mountain College
> Email: jmoss@coloradomtn.edu
> http://www.coloradomtn.edu/programs/sao/home.html
>
> Adjunct Professor: The Department of Parks, Recreation, and Tourism,
> University of Utah
> Outdoor Recreation Risk Management, Insurance and Law
> http://www.health.Utah.edu/prt/ Info: outdoor.law@gmail.com
>
> PO Box 16743
> Golden, CO 80402
> 303-807-2275
> Personal Email: jhmoss@gmail.com
> -------------------------------------------------------
> Scouting E-mail Discussion Lists @ usscouts.org
> Subscribe/Unsubscribe at http://usscouts.org/lists/
> Listserv Commands at http://usscouts.org/lists/lc.asp
> -------------------------------------------------------
> Send listserv commands to: listserv@troop47.com
> Send postings to: philmont@troop47.com
> List FAQ found at: http://usscouts.org/lists/faq.asp
> List Administrator: philmont_owner@troop47.com
> -------------------------------------------------------
> As you gather around this virtual campfire with fellow
> Scouts and Scouters, do your best to be trustworthy,
> loyal, helpful, friendly, courteous, kind, obedient,
> cheerful, thrifty, brave, clean and reverent.
> -------------------------------------------------------
>
>
>
>
>
>
>
>
>
>
>
> -------------------------------------------------------
> Scouting E-mail Discussion Lists @ usscouts.org
> Subscribe/Unsubscribe at http://usscouts.org/lists/
> Listserv Commands at http://usscouts.org/lists/lc.asp
> -------------------------------------------------------
> Send listserv commands to: listserv@troop47.com
> Send postings to: philmont@troop47.com
> List FAQ found at: http://usscouts.org/lists/faq.asp
> List Administrator: philmont_owner@troop47.com
> -------------------------------------------------------
> As you gather around this virtual campfire with fellow
> Scouts and Scouters, do your best to be trustworthy,
> loyal, helpful, friendly, courteous, kind, obedient,
> cheerful, thrifty, brave, clean and reverent.
> -------------------------------------------------------
>
>
>
>
>
>
>

-------------------------------------------------------
Scouting E-mail Discussion Lists @ usscouts.org
Subscribe/Unsubscribe at http://usscouts.org/lists/
Listserv Commands at http://usscouts.org/lists/lc.asp
-------------------------------------------------------
Send listserv commands to: listserv@troop47.com
Send postings to: philmont@troop47.com
List FAQ found at: http://usscouts.org/lists/faq.asp
List Administrator: philmont_owner@troop47.com
-------------------------------------------------------
As you gather around this virtual campfire with fellow
Scouts and Scouters, do your best to be trustworthy,
loyal, helpful, friendly, courteous, kind, obedient,
cheerful, thrifty, brave, clean and reverent.
-------------------------------------------------------

 
Received on Thu Dec 1 16:53:38 2005