Paramedics prepared for EpiPen shortage
Ambulances carry injectable epinephrine
WATERLOO REGION — Region of Waterloo Paramedic Services is prepared for the looming EpiPen shortage.
Paramedics are well stocked with injectable epinephrine and other medications to treat patients who are suffering a serious allergic reaction.
“It concerns us for the people who have prescriptions and carry EpiPens. We don’t carry EpiPens,” said deputy chief Robert Crossan.
Manufacturer Pfizer Canada said its adult-dose EpiPen will be in “very limited” supply in Canadian pharmacies in August due to a manufacturing issue. New stock likely won't be available until the end of that month.
The company is currently able to provide the children’s injector EpiPen Jr, but in a limited supply that is being carefully managed.
An EpiPen is a device that injects a set dose of epinephrine for emergency treatment of an anaphylactic reaction.
“Anaphylaxis is something that comes on very quickly,” Crossan said. “The symptoms escalate very quickly.”
Within 10 to 15 minutes, an anaphylactic reaction can become critical.
Ambulances are stocked with ampoules of epinephrine that a paramedic draws up with a syringe and delivers a calculated dose based on a patient’s weight.
So far in 2018, Waterloo Region paramedics have administered epinephrine to 83 patients due to a moderate to severe allergic reaction. Some cases were anaphylaxis, while others were moderate allergic reactions that may or may not have progressed to anaphylaxis without intervention.
Paramedics will also administer an injectable antihistamine, a Ventolin masking to aid breathing, and intravenous fluids to counteract any drop in blood pressure.
“We still tend to take these folks up to the hospital to prevent a rebound occurrence of anaphylaxis,” Crossan said.
Administering an EpiPen, like naloxone for an overdose, is an emergency measure and people should still seek medical assistance.
“We always recommend you call 911,” Crossan said.
Anaphylaxis is fairly uncommon in Canada. A 2014 study found there was 92 deaths in Ontario from 1986 to 2011, or an average of 3 ½ a year due to anaphylaxis.
“It doesn’t happen very much, but when it happens it’s a major emergency,” Crossan said.
EpiPen products expire on the last day of the month written on the package, which means those with an August expiry date are good until Aug. 31.
Health Canada is advising people to keep an expired EpiPen and use it if needed and call 911 immediately.