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January/February 2007
The magazine for Canadian camp professionals.
Dealing with
is for frontline treatment only. It treats the rebound reactions can happen as quickly as immediate life-threatening effects of ana- 10 to 15 minutes after the initial injection, Anaphylaxis
phylaxis, but not the underlying problem, additional Epipens and oral antihistamines Besides Epipens, the newest system in the not save a life, as additional treatment with battle against anaphylaxis is the Twinject. It an antihistamine, such as Benadryl, needs to was created as the long-awaited replacement be administered as soon as possible. As well, to the now defunct Anakit. Although its use Within the camp community, ana- an anaphylactic response must be evaluated and administration is the same as an Epipen, its biggest advantage is its ability to deliver recovered because some symptoms can reoc- two doses, particularly for use in rebound a high priority of concern. When it comes to reactions. (About 35 per cent of anaphylactic attacks can have rebound effects, according three choices at their disposal: Epipens, the AVAILABLE TREATMENT
When it comes to treating anaphylaxis reac- tions at camp or during outtrips, the most device with red and green caps — supposed- preventive measures, specialized training for ly to help identify a perceived deficiency staff and treatment and response policies are tried, tested, simple and reliable; not to with the Epipen in that some people might all considerations for a successful program mention it takes seconds to minutes to learn mix up the ends and inject the epinephrine how to use and there isn’t much that can go into a thumb or hand instead of the thigh.
responses. Ultimately, the treatment of ana- wrong with it. As per the name, the Epipen With the Twinject, distributed in Canada by phylaxis is dependant on recognition of its is shaped like a large pen and is adminis- Palladin Labs, the first dose is delivered like signs and symptoms, as well as early inter- tered by simply holding it against the thigh an Epipen, while the second dose requires a vention. Keeping informed of the specific for 10 seconds. Besides its simplicity, advan- advantages and disadvantages of available tages of the Epipen include: direct injection delivering the second dose is that significant anaphylactic treatment systems could help through clothing; generally available with- manual manipulation of a potentially con- out prescription; stores easily; and durable enough to be carried by an active camper on tages of the Twinject are that it generally tems that can be considered for the front does not require a prescription and is priced line treatment of anaphylaxis: the Epipen in the same range as the Epipen, although line of auto-injectors, the new Twinject sys- tem, and the use of epinephrine ampules. administer a single dose. The cost for an Epipen there is also a children’s version. $120 — expensive enough for a camper’s (e.g., wilderness tripping programs) is the person suffering from an anaphylaxis reac- family but even more so if a camp has sup- tion, constricts his or her blood vessels and plemental Epipens on standby at the health- are completely sealed containers that have a care unit, while on wilderness trips and for blood vessels helps maintain blood pressure, any recurring or rebound situations. Also which keeps up perfusion (i.e., oxygen to consider the fact that the epinephrine in the broken off. Its main advantage is the fact that it has a readily available amount of epi- swelling within vascular tissue while relax- ing the bronchi of the lungs that can con- only, one Epipen — in most camp settings price. By utilizing this method, a camp could have equivalent resources to 12 Epipens for reaction. It should be noted that epinephrine Canada Camps
January/February 2007
www.canadacampsmag.com
HEALTH MATTERS cont'd
camp health unit, a 0.3 or 0.5 ml syringe is for every organization but might be worth this method offers the most risk and requires the most training because it creates an added delivered into the deltoid (meaty part of the stress in an existing emergency situation if should always emphasize good training and people are not familiar or comfortable using policy development for prevention, recogni- syringes. Significant training for your staff an anaphylaxis reaction includes using both tion and treatment of anaphylaxis. CC
an Epipen and ampules with syringes. In this instance, the Epipen is delivered for initial Mike Webster is the Canadian executive or wilderness medical and first-aid training director for Wilderness Medical Associates organizations that offer this type of expert- treated with the ampule method. A syringe (www.wildmed.ca), an organization that is drawn up with epinephrine after the initial provides wilderness first-aid and medical This method also requires users to fill a use of the Epipen and only used if there are training for organizations, individuals and syringe from an ampule, which could lead to medical professionals that work or play in unnecessary dosage errors. If ampules are the simplicity of the Epipen, but enjoys the used either for wilderness trips or at the cost saving measures of the ampule. It’s not Originally published in the January/February 2007 issue of Canada Camps.
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Canada Camps
January/February 2007
www.canadacampsmag.com

Source: http://www.odysseymedical.ca/images/photos/1013.pdf