Some of these things I know, but when you are in a stressful situation sometimes they slip your mind. And some of these things are just "observations" I made while all heck was breaking loose. I practice what I'd do if my son ever went into anaphyaxis at least once a week (in my mind, not literally PRACTICE). I feel like it's sort of "muscle memory" or that the practice will get me through everything I need to do while on autopilot. For the most part, it worked. But here's a few "observations" from our recent experience.
1. Keep the used Epi pen.
Since we were at school and in the nurses office, she put the used Epi in the "sharps container" (which was a coffee can... just an observation that seemed odd to me). But when EMS came, they wanted it. They took it with us to the hospital. I don't know if this happens every time, but it happened that day.
2. Volunteer any and all information that you feel is relevant, even if not asked.
There were several things that I had to share with EMS and the ER that no one asked me. ALL turned out to be relevant in my sons care.
*No one asked if I gave him Benadryl or how much. I just shared it and they (both EMS and ER) wrote it down.
*No one asked exactly what his allergies were. They focused on the reaction to nuts but my son has several life threatening food allergies and they all need to be noted.
*No one asked if he had asthma, which he does. To me this is relevant because having asthma can make anaphylaxis deadlier. I shared that information right off the bat with the EMS and the ER.
*No one asked what other meds he was on (or maybe I just beat them to the punch). This seemed like a no brainer to me.
3. Make sure to ride along in the ambulance.
Again, seemed like a no brainer but for a split second I thought about driving and following the ambulance. They have lights and sirens and I don't. No one would know that I was with them so I would not get the same treatment as the ambulance (speeding, driving through intersections and red lights, etc.). I would have been putting the public at risk if I did these things. Or I would have lost the ambulance if I obeyed traffic laws. And I don't even want to think about trying to find parking...
4. Make sure to ride along in the ambulance so YOU can keep an eye on your loved one.
My son was on the stretcher facing the back doors. The EMT that rode in back with us was behind my sons head and not looking at him. At one point I could see something else was going on with my son that the EMT was unable to see (he was checking vitals and vitals were fine but something was happening). I kept asking my son if he was OK and at one point he said his throat was scratchy and it was hard to breathe. THAT'S when they gave him oxygen. Would his vitals have had to dip before he received oxygen? I'd rather not think about it...
5. Once at the ER, volunteer any and all of that relevant information to anyone who comes in contact with your child.
I shared all of #2 with any nurse or doctor that came in contact with my son.
6. Read labels in the ER and/or double check food safety.
My son was hungry once things calmed down and he started to feel better. We didn't have food on us as we weren't expecting to be in the ER for 4 hours. They happened to have a few things and offered it to him. He was able to eat the jello and the Popsicle but Teddy Grahams and Gold Fish are not safe for him (but they did mention those items to him... ). We also found some prepackaged safe snack items in the vending machine and at the snack bar.
This next one was something that happened inadvertently but gave me great concern.
7. Make sure the area that you are injecting the Epi Pen is clear of obstacles.
Yes, that probably sounds very strange.
My son was seated while I gave him the Epi Pen. I happened to touch his outer thigh were I was going to inject him and I felt something hard right in that spot. I reached into his pocket and pulled out the biggest wad of tissues I've ever seen. The Epi may have penetrated through the tissues, but I don't know. They felt like a medium sized ball. I'm glad that I randomly touch him there. It never occurred to me that something in a (very large and deep) front pocket might cause the Epi to not fully penetrate the skin (this is another good reason to always carry TWO Epi's with you). This got me to thinking about all the other things that could be a hazard (especially for adults): Wallets, money clips, cell phones, credit cards or I.D. cards, car keys, etc.
8. Make sure to get a replacement prescription for your used Epi Pen before leaving the ER.
Even if you have extras at home, replace the used one right away.
These are a few random things that really struck me at the time. I'm sure as I run through all of this in my mind over the next few weeks more things will pop up that I found to be relevant to this type of situation but at the time, these were the biggies.
And I hope you never, ever have to use any of these.
7 comments:
So sorry you had to go through that but thanks for sharing. This is a terrific list! Your mommy instincts sure kicked in.
Good stuff, especially #7. A young man died last year in our area, a college student who carried his Epi and self-injected, but the needle broke. :( I never heard for sure, but I've always wondered if he hit an obstruction like you describe and that's what happened.
A corollary to that is always carry two Epis, get the Twin-Pak prescribed. Just in case.
Thanks for sharing your experience!
Thank you for this post; would have never thought to look in his pockets. Hope you all stay well! Deep breathe, you are a great mom!
I think this is a great list and thank you for sharing. My husband always pulls his pant down when he uses his epi pen.
I did read that you are supposed to take (as I call it) the Epi carcass with you to the ER.
So you can give it straight through clothes, given that there are no obstacles in the way? Good to know.
Good info on the ambulance.
A coffee can? Don't they charge you enough in tuition to secure a proper containment system? My guess is yes.
People also need to make sure that they keep their fingers out of the way of the shot. I've read that you can cause some digit issues if you accidentally inject yourself. Another thing to mention to medical folks.
Ooo! No Epi to the butt! To the thigh only, yes? (I'm new at this, but have read the instructions several times.)
I found that when I was in the hospital and even though it was posted to the chart and on the door, my allergy to Iodine was continually overlooked. They doused me with Iodine prior to giving me my central line. Mom yelled at them and they hurried to wipe it back off. Now, I didn't have a skin reaction, so they think that my sensitivity (moreso appropriate, I'm sure) is more an interior type of thing. Still, it was posted and they (in the hospital and with my being deathly ill anyhow) couldn't manage to keep that one straight without people continually reminding.
Fact of the matter is, you have to be the advocate for your loved one and you may feel like you sound like a broken record, but the folks take care of so many people, it is fast paced and you only have one to look after. Don't be afraid to step up and continually remind, if needed.
Wow. Glad he is okay.
Great article! There are a few more tips in here as well:
http://foodallergybitch.blogspot.com/2012/02/critique-of-food-allergy-reaction.html
Great post! I completely agree with you to have the patient ride to the hospital in the ambulance and not driven by a parent. I learned this the hard way when I did drive my then 4 year old son to the hospital after having to administer the epipen due to an anaphylactic reaction (which, btw, the only symptom was the throat starting to close up and a weird sounding cough). Upon arriving to the ER, they wanted me to sign in and wait until they called him back. I refused and told when they told me he could breathe and was out of danger, then I would sign in and give them my insurance info. I would not take no for an answer, and they did take him back immediately, if for no other reason than to shut up the crazy woman. If we had been in an ambulance, he would have been seen right away without all the drama. I hope I never have to do this again; it was the scariest day of my life. I am glad your little man is ok now.
Caron T
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