State senator (R) offers an alternative to costly EpiPen - and a response (not mine) [View all]

[question everything]

Last week Sen. Paul Anderson hosted a town hall with Sen. Michelle Benson as guest. One man asked what our leaders could do to fix skyrocketing drug costs. His grandson has anaphylactic allergies and the family can no longer afford his EpiPen. Sen. Benson’s answer was that people “need more skin in the game” and his grandson could carry a glass vial of epinephrine and a syringe to save money.

To that end, I have attached directions for injecting Epinephrine from a glass vial:

1. Time is of the essence. Do the following without delay:

2. Locate the 1cc tuberculin syringe with 1/2 or 5/8 inch, 25, 26, or 27 gauge needle.

3. Break the neck of the glass vial at the scored site in one fluid motion to avoid glass shards.

4. FULL CONTENTS OF THE VIAL MUST NOT BE GIVEN IN ONE DOSE. Give only the correct dose based on patient’s weight.

5. Turn vial at slant without tipping or contents will be lost. Loosen plunger with 1-2 dry pumps. Draw up slightly more than calculated dose.

6. Turn needle up, tap side of barrel, when air bubbles go to the top, push the plunger tip up to exact dosage. Give (calculated amount) cc of 1:1000 Epinephrine.

7. Clean injection site with alcohol (if no alcohol proceed anyway).

8. Give injection intramuscularly in upper arm, deltoid, or middle third of outer thigh.

9. Pinch two-inch fold of flesh. With fluid motion inject the needle fully at 90 degrees.

10. Release pinched tissues. While holding barrel with one hand, retract plunger, looking for for blood. If there is blood, pull the needle out and try a new site.

11. If no blood, push plunger to inject Epinephrine. Pull the needle from the skin. Apply pressure.

12. Transport patient to nearest emergency room.

Although Sen. Benson recommends the above substitution to save money, as a physician I can’t recommend it. Instead, I recommend our leaders grow backbones and stand up to predatory pharmaceutical pricing.

Allison Stolz, MD
Minnetonka

http://abcnewspapers.com/2017/04/20/letters-to-the-editor-for-april-21-2017/