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Law gives medics more treatment freedom

"FD 3 volunteer Doug Neal (right) shows Eldon Baker the technique for using an epi-pen. District volunteers are allowed to use the devices to deliver epinephrine in clear life-and-death situations thanks to a new state law.Matt Johnson, staff phottoAn addendum to a three-year-old state law will allow emergency medical technicians around the state to administer a powerful drug in their medical kit more freely.Last week, Gov. Gary Locke signed a bill that will allow EMTs to use epinephrine to treat patients suffering from anaphylactic shock without getting a prescription beforehand.The bill amends the 1999 Kristine Kasner Act, which required all basic life support vehicles to carry epinephrine at all times. Kasner, a Washington girl, died of anaphylactic shock, partially due to the fact that emergency medical responders did not have epinephrine on hand. Her parents pushed legislators to pass the bill.Fire District 3 has stocked its EMT medical kits with epinephrine since the act's passage. Each kit is equipped with two adult-dose and two child-dose Epi Pens, devices that deliver a pre-measured amount of epinephrine. But until the governor signed the amendment to the Kasner Act, EMTs could use the drug only when a patient could produce a prescription, or when a doctor ordered the drug be given.Darin Reid, battalion chief for the district's special services arm, said the new law will allow EMTs to give better treatment when the signs of anaphylactic shock, also known as anaphylaxis, are evident. Nonetheless, he said people who know that a bee sting, peanuts, or other allergens can send them into anaphylactic shock should prepare themselves rather than rely on EMTs.We highly recommend that you carry your own pen with you, he said.EMTs may now administer epinephrine to patients of any age who have a prescription for the drug. To use the drug on a patient under 18 years of age, it must be requested by the patient or his or her parent or guardian, or requested by a person who presents written authorization from the patient or his or her parent or guardian. Though the law does not state it explicitly, Reid said EMTs are allowed to use their own judgement as to whether or not to administer epinephrine to patients under the age of 18.Paramedics are not affected by the new law. Larry Wall, the medical service training coordinator for Whidbey General Hospital, said hospital paramedics are under a doctor's protocol for using epinephrine. Paramedics carry the drug in bulk form and measure it out for individual patients. They do not need a prescription or parental permission to use the drug on a patient who is obviously suffering from anaphylaxis.The state law protects EMTs, medical service agencies, and medical program directors from liability when epinephrine is given under these conditions. However, the law does have its limits. First responders, who have less medical training than EMTs but who do assist in medical emergencies, are not allowed under any circumstances to administer epinephrine.Epinephrine is a form of adrenaline and can cause an increase in heart rate and respiration. Reid and Wall said the drug must be used carefully, because it has been known to cause heart attacks in patients with heart disease. The Epi Pens the district is required to carry cost $42.66 each and must be replaced once a year. Those replacements cost FD 3 more than $1,000 a year. Since the Kasner Act was passed, EMTs have used the pens twice, Reid said. "

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