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Use of epi vials vs epi-pen auto injector on emergency carts / RRT

  • 1.  Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-14-2024 12:58

    Hello!

    I wanted to see what other practices are in this area. We currently have vials of epi (1mg/ml) that are utilized in our RRT carts for our clinic sites but are looking into switching over to epi-pens (having an adult and pediatric version) as it reduces risk of medication error and would be faster to administer. I wanted to ask if others utilize epi-pens vs epi vials as standard stocking for severe allergic reactions? 



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    Ryan Reid RN
    UT Southwestern Medical Center
    Richardson TX
    (717)433-0868
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  • 2.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-15-2024 08:03

    Our organization switched to epi pens last year. We have anaphylaxis kits in our clinics and we now stock the epi pens instead of the vials in these kits. We have pediatric and adult anaphylaxis kits depending on the population served in that clinic. We also have a protocol that allows nurses to give the meds in the kit in emergency situations if a provider is not present. 



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    Lindsay Miller MSN, RN, AMB-BC
    Ambulatory Nursing Professional Development Specialist
    lmiller3@metrohealth.org
    The MetroHealth System
    Cleveland, Ohio
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  • 3.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 04-13-2024 15:23

    Would you be willing to share your protocol or what references you used to develop this protocol? I am working on refinement of our anaphylaxis emergency cart & kit used in our allergy clinic. 



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    Olivia Burden BSN RN CIC
    Clinical Staff Operations Manager
    Ohio County Healthcare
    Beaver Dam KY
    (270)929-5951
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  • 4.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-15-2024 10:12

    Hi Ryan,

     

    We have the Epi vials on our ambulatory carts...

     

     

     

    Rhonda Edwards, BSN, RN, AMB-BC, CPN

    Texas Children's Hospital                                          

    Spina Bifida Nurse - Clinical Care Center 

    Office #: 832-822-3317                                                           

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  • 5.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-15-2024 11:16

    Greetings,

    Our organization uses a vial. It is an Epi Convenience Kit that comes with syringes, needles, and vial. It is much more cost effective than the auto-injectors.

     

    Thank you,

     

    Sharon J-J Peacock, MSN-Ed., RN, AMB-BC

    Nursing Professional Development Generalist

    Sentara Ambulatory Services Division

     

    Office: 434-654-4529

    Email: SJPEACOC@sentara.com | SASDClinEduTeam@sentara.com

    590 Peter Jefferson Parkway, Suite 323, Charlottesville, VA 22911

     

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  • 6.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-17-2024 14:08

    we use epipens which cost $0.04 each box in our 340B program...so depending on your ability to purchase for your community through your pharmacy programs, it may actually be better to use pens. A lot of people think they are expensive, but they may not be if you have access to a 340B program. 

    My biggest complaint is disposal---epi is typically p-listed hazardous pharmaceutical waste, which is heavily regulated, and depending on your state, even an empty vial may be required to be disposed of in p-listed waste containers. This would be my only reason to consider moving away from pens...just because they take up much more space in my bins. But from a safety perspective, my teams MUCH prefer having the pens for use than vials. 



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    Mary Blankson DNP APRN FNP-C FAAN
    Chief Nursing Officer
    Community Health Center, Inc.
    Middletown CT
    (860)227-5432
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  • 7.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-18-2024 10:05

    Hi Ryan, 

    We currently use Epi vials in our emergency response boxes. We are currently switching at some of our sites, however, to Epi Pens because they do not require a dual nurse sign off per our organizations standards. We have a few of our convenient care locations that have only one APN and one MA staffed at a time. So the APN would give the Epinepherine and have no one to sign it off, since MAs are not able to co-sign on medications at our organization. It is not the most cost effective plan but we need some way to give care safely and per regulatory standards. I am wondering if anyone else has this issue as well with the dual sign off? Just curious! 

    Kimmie



    ------------------------------
    Kimmie Vavra, MSN RN
    Quality Assurance and Clinical Educator
    Rush Copley Medical Group
    1256 Waterford Drive, Suite 230
    Aurora, IL 60504
    Office: 630-499-6682
    Cell: 630-456-3514
    ------------------------------



  • 8.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-19-2024 10:11

    Hi Ryan!  Great question!

    I work in a pediatric hospital system, ambulatory.  We have some areas that use the ampules.  These areas have more staffing resources like multiple RNs.  Some of our areas are off campus and are only staffed with a provider and an MA.  Those areas have the pens.  We did this because of the level of skill, low frequency, and the urgency of the need.  



    ------------------------------
    Annette
    Annette Hamlin, MSN, Ed., AMB-BC, RN
    Nursing Professional Development Specialist
    Ambulatory, Medical/Surgical Administration
    Akron Children's Hospital
    Akron, OH
    330 618 6357
    ------------------------------



  • 9.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-20-2024 08:46
    I am a charge nurse in an ortho clinic. In our Ambulatory clinics we have the ampule/IV. Our ambulatory clinics are transitioning to RNs as leaders versus staff and we do not always have an RN in the clinic. But we do have providers who can start the IV. I think transitioning to epi pens is a great idea and one I will research to bring to our leadership

    Charlotte Chavous BSN, RN, AMB-BC, CSFA, CST, CHT, TTS
    Charge Nurse
    Nashville Orthopaedics Antioch
    4249 Century Farms Terrace
    Nashville, TN 37013
    P: 615-936-7846





  • 10.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-20-2024 09:50

    Just to clarify, we do not give epi IV. It is a IM injection, but our protocol wants and IV started



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    Charlotte Chavous BSN RN
    Practice Nurse
    Vanderbilt University Medical Center
    Murfreesboro TN
    (615)975-9087
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  • 11.  RE: Use of epi vials vs epi-pen auto injector on emergency carts / RRT

    Posted 03-20-2024 16:43
    We use Epi pens but remember to clearly mark the difference between adult versus pediatric dosing and to include peds dosing guidelines alongside the epi pens (pediatric).
    Toni Kempner, MSN, RN
    Regional Nurse Manager
    East County Health Center 600 NE 8th St, Gresham, OR 97030
    Rockwood Health Center 2020 SE 182nd, Portland, OR 97233
    Multnomah County Health Department 
    Portland, OR 97209
    503-969-6989 work cell phone

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