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RNOfficer
Seasoned Member

Posts: 232

« on: August 24, 2016, 11:39:59 PM »

We've all seen stories about the greatly increased cost of Epipens, which could be a real hardship for some members.

While schools usually have an Epipen on hand, most pediatricians believe that a child with allergies should carry his/ her own.

The manufacturer has a "savings plan" for those who qualify

https://www.activatethecard.com/epipen

And here's information about an alternative you can discuss with your health provider

http://www.consumerreports.org/drugs/how-to-get-cheaper-epipen-alternative/
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Eclipse
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« Reply #1 on: August 24, 2016, 11:45:38 PM »

How is this related to CAP?
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"Effort" does not equal "results".
The contents of this post are Copyright © 2017 by eclipse. All rights are reserved. Specific permission is given to quote this post here on CAP-Talk only.

RNOfficer
Seasoned Member

Posts: 232

« Reply #2 on: August 24, 2016, 11:51:53 PM »

How is this related to CAP?

CAPR 160-1    3 JUNE 2013
3
CHAPTER 1 – ORGANIZATION AND FUNCTION
1-  1.
General Considerations.
  People are the most valuable asset of any organization.  This is especially true of any organization such as CAP.  In order for those people to perform their tasks well,  they  should  be  optimally  healthy,  physically  fit and  well-trained.    Physical  fitness,  health  promotion,  environmental  protection and  skill  and  knowledge  in  providing  emergency  care  are  readiness issues.  Training at every level must reflect these issues.  Since CAP is an integral part of the Air Force family, a program reflecting the foregoing is necessary.  CAP Health Service’s overarching program goal is to a
ssist our entire membership to become and/or remain optimally healthy and fit.
values
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Eclipse
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« Reply #3 on: August 25, 2016, 12:00:37 AM »

This is none of CAP's business beyond being aware if a cadet needs one, and that is a confidential issue.

Despite your assertions, CAP is not in a position to influence these types of issues, nor is it supposed to
be a primary care provider, or even a source for this kind of information.
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"Effort" does not equal "results".
The contents of this post are Copyright © 2017 by eclipse. All rights are reserved. Specific permission is given to quote this post here on CAP-Talk only.

PHall
Salty & Seasoned Contributor

Posts: 5,836

« Reply #4 on: August 25, 2016, 12:02:34 AM »

So you've unilaterally decided that you're everyone's Health Services Officer?
That's pretty bold.
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RNOfficer
Seasoned Member

Posts: 232

« Reply #5 on: August 25, 2016, 12:05:08 AM »

This is none of CAP's business beyond being aware if a cadet needs one, and that is a confidential issue.

Despite your assertions, CAP is not in a position to influence these types of issues, nor is it supposed to
be a primary care provider, or even a source for this kind of information.

Not an assertion but as the above post shows a Regulation CAPR 160-1
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Eclipse
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« Reply #6 on: August 25, 2016, 12:11:12 AM »

Training should be relevent to CAP, not the random FUD of the day off Snopes.
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"Effort" does not equal "results".
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RNOfficer
Seasoned Member

Posts: 232

« Reply #7 on: August 25, 2016, 12:11:24 AM »

So you've unilaterally decided that you're everyone's Health Services Officer?
That's pretty bold.

I'm not your HSO. I just post well-documented health news that is of general interest and importance to the health and safety of CAP members.

Members may be concerned about access to Epipens. Reliable information is not easy to find in the overload of often incorrect information available, especially on the web.
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Eclipse
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« Reply #8 on: August 25, 2016, 12:13:29 AM »

news that is of general interest and importance to the health and safety of CAP members.

This is not.  If you gave a briefing on epi-pen costs at a unit meeting, that would be the last time you
gave one for quite a while, for the same reasons I don't allow SEs to start talking about AOPA political issues.
It's not relevent to the majority of the members, and those so inclined can seek out find that information on their own.


Members may be concerned about access to Epipens. Reliable information is not easy to find in the overload of often incorrect information available, especially on the web.

Again, this was all over the tubes today, most local news, and pushed all over FB by "concerned" people.

It's also not "news", certainly not to anyone who actually needs one.  The only reason it was in the news cycle today
was because a Senator has decided to make it an issue.
« Last Edit: August 25, 2016, 12:19:57 AM by Eclipse » Logged

"Effort" does not equal "results".
The contents of this post are Copyright © 2017 by eclipse. All rights are reserved. Specific permission is given to quote this post here on CAP-Talk only.

Nick
Seasoned Member

Posts: 468
Unit: SWR-TX-001

« Reply #9 on: August 25, 2016, 12:19:40 AM »

And people wonder why we have a retention problem in CAP. Here we have a CAP health service officer sharing news about a health related issue, however saturated the news cycle may be, and s/he is berated into submission by the masses because they personally disagree with the message.

Guys, if you have a personal objection to what someone shares, just ignore it and move on with your life. Ridiculing someone is not the way to win the hearts and minds, eh?


Sent from my iPhone using Tapatalk
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Nicholas McLarty, Lt Col, CAP
Texas Wing Staff Guy
National Cadet Team Guy
RNOfficer
Seasoned Member

Posts: 232

« Reply #10 on: August 25, 2016, 12:21:03 AM »

news that is of general interest and importance to the health and safety of CAP members.

This is not.  If you gave a briefing on epi-pen costs at a unit meeting, that would be the last time you
gave one for quite a while, for the same reasons I don't allow SEs to start talking about AOPA political issues.
It's not relevent to the majority of the members, and those so inclined can seek out find that information on their own.


Members may be concerned about access to Epipens. Reliable information is not easy to find in the overload of often incorrect information available, especially on the web.

Again, this was all over the tubes today, most local news, and pushed all over FB by "concerned" people.

My posts do not treat it as a political issue but rather as a health issue. For it to be of importance I do not think there is any requirement that it be of interest to a "majority" of members.

If you are not interested in the subject, I suggest you do not read it.
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grunt82abn
Seasoned Member

Posts: 201

« Reply #11 on: August 25, 2016, 10:14:31 AM »

Here we go again!!!
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Sean Riley, TSGT
US Army 1987 to 1994, WIARNG 1994 to 2008
DoD Firefighter Paramedic 2000 to Present
PHall
Salty & Seasoned Contributor

Posts: 5,836

« Reply #12 on: August 25, 2016, 11:14:48 AM »

So RNOfficer, do you post anywhere else or just to the very limited number of people who are here on CAPTalk?
Because if this is the only place you post, you're not getting much bang for your buck.
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A.Member
Salty & Seasoned Contributor

Posts: 1,606

« Reply #13 on: August 25, 2016, 11:20:50 AM »

news that is of general interest and importance to the health and safety of CAP members.

This is not.  If you gave a briefing on epi-pen costs at a unit meeting, that would be the last time you
gave one for quite a while, for the same reasons I don't allow SEs to start talking about AOPA political issues.
It's not relevent to the majority of the members, and those so inclined can seek out find that information on their own.


Members may be concerned about access to Epipens. Reliable information is not easy to find in the overload of often incorrect information available, especially on the web.

Again, this was all over the tubes today, most local news, and pushed all over FB by "concerned" people.

My posts do not treat it as a political issue but rather as a health issue. For it to be of importance I do not think there is any requirement that it be of interest to a "majority" of members.

If you are not interested in the subject, I suggest you do not read it.
As others stated, the price of an epipen or any other medical item is not a CAP issue.  Further, this is not new but rather just the latest increase.  The prices have been increasing for 5 - 10 years.

Does a member require an epipen for an allergy?  If yes, do they know where it is and how to use it, if needed?  That is where the CAP interest in this issue begins and ends.
« Last Edit: August 25, 2016, 11:24:47 AM by A.Member » Logged
"For once you have tasted flight you will walk the earth with your eyes turned skywards, for there you have been and there you will long to return." - Leonardo da Vinci
DakRadz
Salty & Seasoned Contributor

Posts: 1,351

« Reply #14 on: August 25, 2016, 12:31:09 PM »

So RNOfficer, do you post anywhere else or just to the very limited number of people who are here on CAPTalk?
Because if this is the only place you post, you're not getting much bang for your buck.
I would make that argument the other way around- since the average unit is rather small, why CAP? Couldn't you affect more people through a bigger or more well known program?

That particular motive is irrelevant- we all chose CAP.


Also, one post every day or two on the Safety board isn't that bad. And, in general, RN Officer tends to avoid the political side of these  (though I have seen the mods remove improper/non-neutral links).

I think this opens a good discussion, specifically on the fact that something like 88% of people actually don't notice this increase because of insurance or assistance. But maybe the next cadet who says they have a bad allergy, make sure the EpiPen or equivalent is actually on their person- and yes, I feel we should  check this for our 12 year old members.

While recent posts show that maybe someone should have a talk specifically with the OP about giving a short summary of how this is relevant, and maybe leave Zika out, let's reconsider attacking every post. There is a level of goodwill and dedication, and this isn't a meeting, it is a message board. I wouldn't argue about the effectiveness of ABU in a field environment at the Tues meeting. Nor would I be able to draw on the experience here.

We have our MCoC, but I wouldn't say this works exactly as weekly meetings do.

1st Lt Raduenz

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Mordecai
Salty & Seasoned Contributor

Posts: 1,052
Unit: SI

« Reply #15 on: August 25, 2016, 12:34:08 PM »

You know, the thing that would make this far more relevant is not so much the cost, but how the operation of the adrenaclick is different from the operation of an epipen.

THAT is something that is worth covering here, especially as more people find out about alternatives to the brand name epi-pen.
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stillamarine
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Unit: SER-AL-134

« Reply #16 on: August 25, 2016, 12:44:49 PM »

I worked the schools for the last 5 years. Every time there was a medical emergency we were called (our radios are faster than calling 911). None of the schools I worked had an epipen in it's inventory. One had one that a student that had one prescribed brought and left at the school.
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Tim Gardiner, 1st LT, CAP

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Mordecai
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Posts: 1,052
Unit: SI

« Reply #17 on: August 25, 2016, 12:46:31 PM »

I imagine that any school that had them in inventory probably has an expired inventory. Prescription drugs generally aren't kept "on inventory" unless you have someone licensed to use them.
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DakRadz
Salty & Seasoned Contributor

Posts: 1,351

« Reply #18 on: August 25, 2016, 12:53:15 PM »

You know, the thing that would make this far more relevant is not so much the cost, but how the operation of the adrenaclick is different from the operation of an epipen.

THAT is something that is worth covering here, especially as more people find out about alternatives to the brand name epi-pen.
This. Redirection instead of rejection and ejection. Perhaps also tied in to an activity that you are highly likely to need this information.

4.5 years in EMS hasn't seen me use an EpiPen, but the irony is I expect it will be an encampment or other CAP activity because of the high concentration of allergies I've seen.

1st Lt Raduenz

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Spaceman3750
Salty & Seasoned Contributor

Posts: 2,605

« Reply #19 on: August 25, 2016, 01:33:38 PM »

If we see an uptick in cadets at activities with severe allergies that SHOULD have an Epi-Pen according to their doctor, but don't because of the cost, this suddenly becomes related to CAP; a cadet who is likely to have their airway close up following a sting, who is not carrying an Epi-Pen, is at significantly higher risk of injury than their peers.

The counter-point to that argument is that if you can't afford a $300 life-saving medication (a cost which, as has been pointed out, will likely be blunted in some way by insurance for most people), you are not likely to be sending your cadet to CAP or CAP activities anyways, due to the cost of the program itself. I wouldn't say that is 100% true, but it's probably true more often than not.

My .02 anyways, don't spend it all in one place.
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The moment any commander or staff member considers themselves a gatekeeper, instead of a facilitator, they have failed at their job.
I can't fix all of CAP's problems, but I can lead from the bottom by building my squadron as a center of excellence to serve as an example of what every unit can be.
PHall
Salty & Seasoned Contributor

Posts: 5,836

« Reply #20 on: August 25, 2016, 02:12:39 PM »

I imagine that any school that had them in inventory probably has an expired inventory. Prescription drugs generally aren't kept "on inventory" unless you have someone licensed to use them.

They only have a "shelf life" of 1 year. Which means a school would need to replace them every school year at a minimum.
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SarDragon
Global Moderator

Posts: 10,019
Unit: NAVAIRPAC

« Reply #21 on: August 25, 2016, 06:13:18 PM »

Is that the "Discard after" date from the pharmacy, or the actual expiration date from the package? Sometimes there is a big difference.

Sent from my phone.

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Dave Bowles
Maj, CAP
AT1, USN Retired
Mitchell Award (unnumbered)
C/WO, CAP, Ret
grunt82abn
Seasoned Member

Posts: 201

« Reply #22 on: August 25, 2016, 06:21:57 PM »

The other option people have, with allergies, is to obtain a vial of Epinephrine 1:1000 and a needle and syringe, draw it up and stick yourself. My department does this as a cheap alternative to the EpiPen. 
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Sean Riley, TSGT
US Army 1987 to 1994, WIARNG 1994 to 2008
DoD Firefighter Paramedic 2000 to Present
DakRadz
Salty & Seasoned Contributor

Posts: 1,351

« Reply #23 on: August 25, 2016, 09:19:43 PM »

The other option people have, with allergies, is to obtain a vial of Epinephrine 1:1000 and a needle and syringe, draw it up and stick yourself. My department does this as a cheap alternative to the EpiPen.
In many instances, there is a provision covering the specific use of EpiPens and similar devices, which does not cover this route.
Whether a law, policy, or protocol- EMTs have never been allowed to draw up epi where I've worked, but they could do devices.



Also consider that the suffocating patient probably won't have the mind or dexterity to draw up the med. And if they can, why epi? It is an emergency med. Probably better served with benadryl and driving to urgent care. Works great from the health professional view, but looks way different from the patient view.

Not trying to browbeat you- if it seemed that way I apologize.

1st Lt Raduenz

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sarmed1
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Posts: 898

« Reply #24 on: August 25, 2016, 09:20:37 PM »

The other option people have, with allergies, is to obtain a vial of Epinephrine 1:1000 and a needle and syringe, draw it up and stick yourself. My department does this as a cheap alternative to the EpiPen.

There are kit out there I have seen similar to this, the epi pen is just "easier" for most people I would gather.

The other cost tie in relevance I see is: what if you need to pick one up for a cadet after an exposure that they used theirs, or get prescribed one upon discharge in the case of an unknown allergy hospitalization during at a week long type activity?  It might be good to be know that they arent $50, and you can discuss with mom and dad or the hospital about getting the generic brand ok'd for substitution, searching for a coupon etc etc....

mk
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Mark Kleibscheidel
TSgt USAFR
sarmed1
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Posts: 898

« Reply #25 on: August 25, 2016, 10:06:17 PM »

I would also say a more appropriate briefing/topic would be about causes & recognition of severe allergic reactions and when to use/assist in the use of epi pens in such an emergency prior to EMS arrival.  Honestly, I would rather have someone not know how expensive it is to replace,  in fear that cost info may cloud their judgement on when to or not to use it in fear that they dont want to "waste it" if they arent sure if someone really needs it or not. 

It is also not outside the realm of possibility that little johnny doesnt really know how to use it (or isnt going to be able to be rational enough to use it) in a real life situation and someone semi-responsible may need to step in.  There are plenty of people out there that I encounter that have been prescribed one, due to a one time incident, but have never had to use it.  My medical guy advice would be that if you have people in your unit or activity that you know have epi pens, you make sure that you are at least familiar with the kind they carry.  (also there are other types of auto injectors/pens out there for other conditions that may be important to know about)

mk
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Mark Kleibscheidel
TSgt USAFR
RNOfficer
Seasoned Member

Posts: 232

« Reply #26 on: September 08, 2016, 09:26:17 PM »

http://www.kevinmd.com/blog/2016/09/epipen-expensive-4-options.html
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grunt82abn
Seasoned Member

Posts: 201

« Reply #27 on: September 10, 2016, 09:25:15 PM »

http://www.kevinmd.com/blog/2016/09/epipen-expensive-4-options.html

You shouldn't be putting this out there!!! Condoning the use of an expired medication, suggesting to hold on awhile, or suggesting your child might not need one is setting someone up for liability, especially when it comes to pediatrics (i.e. Cadets). I know you mean well, but information put out from a non-reliable source is setting someone up for failure.
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Sean Riley, TSGT
US Army 1987 to 1994, WIARNG 1994 to 2008
DoD Firefighter Paramedic 2000 to Present
grunt82abn
Seasoned Member

Posts: 201

« Reply #28 on: September 10, 2016, 09:37:31 PM »

The other option people have, with allergies, is to obtain a vial of Epinephrine 1:1000 and a needle and syringe, draw it up and stick yourself. My department does this as a cheap alternative to the EpiPen.
In many instances, there is a provision covering the specific use of EpiPens and similar devices, which does not cover this route.
Whether a law, policy, or protocol- EMTs have never been allowed to draw up epi where I've worked, but they could do devices.



Also consider that the suffocating patient probably won't have the mind or dexterity to draw up the med. And if they can, why epi? It is an emergency med. Probably better served with benadryl and driving to urgent care. Works great from the health professional view, but looks way different from the patient view.

Not trying to browbeat you- if it seemed that way I apologize.

1st Lt Raduenz

No need to apologize! Just giving a cheap option. There used to be kits, set up much like Glucagon kits used today, that were issued in the military. They were super cheap, easy to use, and were allowed at the basic level, and self aid. Instead of an auto injector, it was a pre-filled syringe, ready to use.

Benadryl is good, but I have had cases where it wasn't enough, or quick enough to contain sudden onset anaphylaxis, and created some hairy situations when our squad arrived on scene.
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Sean Riley, TSGT
US Army 1987 to 1994, WIARNG 1994 to 2008
DoD Firefighter Paramedic 2000 to Present
SarDragon
Global Moderator

Posts: 10,019
Unit: NAVAIRPAC

« Reply #29 on: September 11, 2016, 12:51:33 AM »

No need to apologize! Just giving a cheap option. There used to be kits, set up much like Glucagon kits used today, that were issued in the military. They were super cheap, easy to use, and were allowed at the basic level, and self aid. Instead of an auto injector, it was a pre-filled syringe, ready to use.

Benadryl is good, but I have had cases where it wasn't enough, or quick enough to contain sudden onset anaphylaxis, and created some hairy situations when our squad arrived on scene.

Ah, yes, the atropine syrette. I remember those well. They were actually replaced by auto-injectors some time in the '80s. Currently called the MARK I. NERVE AGENT ANTIDOTE KIT (NAAK).
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Dave Bowles
Maj, CAP
AT1, USN Retired
Mitchell Award (unnumbered)
C/WO, CAP, Ret
sarmed1
Salty & Seasoned Contributor

Posts: 898

« Reply #30 on: September 15, 2016, 09:05:41 AM »

No need to apologize! Just giving a cheap option. There used to be kits, set up much like Glucagon kits used today, that were issued in the military. They were super cheap, easy to use, and were allowed at the basic level, and self aid. Instead of an auto injector, it was a pre-filled syringe, ready to use.

Benadryl is good, but I have had cases where it wasn't enough, or quick enough to contain sudden onset anaphylaxis, and created some hairy situations when our squad arrived on scene.

Ah, yes, the atropine syrette. I remember those well. They were actually replaced by auto-injectors some time in the '80s. Currently called the MARK I. NERVE AGENT ANTIDOTE KIT (NAAK).

I think he was referring to the actual  epi kits the military distributed.  It was in a small like 2x4 plastic box had prefilled epi syringe with needle attached, alcohol prep and 2 25mg benadrly tablets.

mk
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Mark Kleibscheidel
TSgt USAFR
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