By Henry Ehrlich
The roll-your-own spirit has swept Seattle. Our contributor Jessica Dabler Martin sent me an article from the Seattle Times about the switch by EMTs from autoinjectors to syringes and vials of the medication. The article says:
“Basically, we put together this kit that was cost-effective,” said James Duren, the professional-standards manager for King County Emergency Medical Services. “We made Epi Kits instead of EpiPens.” The program is called “Check and Inject,” and since it was rolled out last year in 31 fire departments, Duren figures it has saved about $150,000 and more than doubled use of epinephrine by area EMTs.
We have been avidly following developments in the epi-sector. What’s missing from the EpiPen/Auvi-Q wars is any competition on price. I asked Jessica if this bargain appealed to her as the mother of food allergic kids. She’s a PhD neuroscientist who teaches biology. If anyone could handle it presumably she could.
Oh heavens, no. I like the idea of vials of epi and syringes for trained people who regularly administer drugs that way in emergency situations. I think the autoinjector is for regular people who are dealing with an allergy (like us!) – minimal chance of messing up in a highly stressful situation.
The whole reason why I liked that discussion is that by lowering the overall costs, they were able to properly educate their EMTs on recognizing anaphylaxis in the first place (you know, it’s not just throat closure and going into shock). The numbers before and after the development of the “kit” on epi administration says that education on recognition may be even more important than just minimal education and throwing a bunch of Epi-Pens at them and hoping for the best.
Thanks, Jess. We have covered the disconnect between allergists and emergency providers on this site before. Epinephrine is the ultimate better-safe-than-sorry medication, with almost no side effects. EMTs shouldn’t have to worry whether some bean counter is going to ask if the patient was “spongeworthy.”* I.e. exhibiting symptoms that justified using a $400 injector. These are pros. They know how to fill a syringe in a hurry, at a cost of about $10.