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

I notice I was not clear in my statement about orally inhaled steroids.
They can be used IN ADDITION TO, not in place of antihistamines.

Sorry for not noticing this before.

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: "Shane Hoffman" <mycales@comcast.net>
To: "Multiple recipients of list philmont" <philmont@troop47.com>
Sent: Thursday, December 01, 2005 4:39 PM
Subject: 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
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>> cheerful, thrifty, brave, clean and reverent.
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> 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.
> -------------------------------------------------------
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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 17:48:09 2005