Breaking open an EpiPen

[BB8730]

Cracking an (expired, of course) EpiPen open is pretty interesting. First of all, the spring in there is under a ridiculous amount of tension. On the first EpiPen I cut open, the spring shot 20 feet across the room and dented a refrigerator. The dent was impressive, too (oops ).

The other thing that was very interesting is that an EpiPen actually has a ton of epinephrine in it. During an injection, the plunger only goes about 1/5th of the way down the tube of epi. If someone was in a rural/wilderness/survival situation, they could break the EpiPen open and get a few more doses if needed.

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[Apollyon]

Autoinjectors have to have a lot of power, because they have to assume they have to get through clothes and such. Now, you might say "but, as long as the needle is in the skin, that's all that matters", and that is true. However, the idea is the same. The person who needs it can be quite adipose, or just have tough skin, and also may be in distress that is leading to possibly panic, so that's not the time for nuance. So, jam it in now, and worry later.

Likewise, that is why there is extra in the cylinder - to make sure you get it. However, your average person would not be able to reuse the autoinjector, and, to get to the additional epi, they would have to destroy the pen to get to it, making it useless to reinject.

It's one time use, then, game over, man! Game over!

 

[docB]

Autoinjectors have to have a lot of power, because they have to assume they have to get through clothes and such. Now, you might say "but, as long as the needle is in the skin, that's all that matters", and that is true. However, the idea is the same. The person who needs it can be quite adipose, or just have tough skin, and also may be in distress that is leading to possibly panic, so that's not the time for nuance. So, jam it in now, and worry later.

Likewise, that is why there is extra in the cylinder - to make sure you get it. However, your average person would not be able to reuse the autoinjector, and, to get to the additional epi, they would have to destroy the pen to get to it, making it useless to reinject.

It's one time use, then, game over, man! Game over!

I love Bill Paxton!

 

[shookwell]

Most have at least 3-4 doses

http://www.wemjournal.org/article/S1080-6032(13)00094-X/abstract

 

[frosted_flake]

Most have at least 3-4 doses

http://www.wemjournal.org/article/S1080-6032(13)00094-X/abstract

That is so cool!

 

[RoadNurse33]

I like to Mcgyver stuff as much as the next guy, but why not just pack an allergic reaction kit in that giant Epi Pen shuttle? Like say

One vial of (EPINEPHrine HCl Injection)
1 mg/mL (30 mL): $8.40

Plus a one mL syringe with an IM needle.

AND

One vial of
Solution (DiphenhydrAMINE HCl Injection)
50 mg/mL (1 mL): $0.98
and another one mL syringe with an IM needle

As opposed to wasting 5 minutes trying to crack open a used Epi Pen (oh don't be so dramatic and just hold your breath while I figure this out) that costs
Solution Auto-injector (Adrenaclick Injection)

0.15 mg/0.15 mL (2): $419.03

0.3 mg/0.3 mL (2): $419.03

Solution Auto-injector (Auvi-Q Injection)

0.15 mg/0.15 mL (2): $555.47

0.3 mg/0.3 mL (2): $555.47

Solution Auto-injector (EPINEPHrine Injection)

0.15 mg/0.15 mL (1): $186.44

0.3 mg/0.3 mL (1): $186.44

Solution Auto-injector (EpiPen 2-Pak Injection)

0.3 mg/0.3 mL (2): $553.20

Solution Auto-injector (EpiPen Jr 2-Pak Injection)

0.15 mg/0.3 mL (2): $553.20


Really, what I'm saying is if you are putting in the effort to get multiple Epi Pens to be prepared you might as well treat the whole reaction for 1/10th the cost with the ability to more rapidly administer additional epi doses if needed.

 

[shookwell]

The point is that if you are in a place with a bunch of people there's a decent chance that someone has an epipen and that there is something sharp around. No one is suggesting you cut open a bunch of epipens and carry them around with you.

 

[RoadNurse33]

The point is that if you are in a place with a bunch of people there's a decent chance that someone has an epipen and that there is something sharp around. No one is suggesting you cut open a bunch of epipens and carry them around with you.

Clearly I didn't communicate this well because I am specifically responding to the paper you posted. I am absolutely not suggesting you cut open an epi pen and carry it around with you. I am saying a couple of things:
1) The duress caused by the situation is why they recommend using an autoinjector over manually drawing up and administering IM epi, but the suggested alternative of cutting open an epi pen is even more complex. Sure, this is directed at non-medical providers giving emergency care. We're all aware that epi in an allergic reaction is one of the most common medication errors in the ER. Replacing one complex procedure with another is not holding much weight in my eyes.
2)The "bulkiness" of an autoinjector is being blown way out of proportion here. I am saying you can treat anaphylaxis in its entirety (benadryl, epi, corticosteroids) in reasonably the same amount of space. I'm not saying carry a pharmacy out there with you.
3)There is no argument from me about the cost. This is the biggest sham in the pharmaceutical industry IMO. They charge an outrageous price for a generic drug, with good bio-availability at 10+ years, delivering the medicine in a device originally designed by the US Military for Mark I kits. Oh and let's give it a 2 year shelf life. Nah. I'm throwing the BS flag on them here.