Challenging historical dogma: should you really have epinephrine autoinjectors in your emergency kit?

Dr. Mark Donaldson, Senior Executive Director Pharmacy Advisory Solutions for Vizient, is the author of an article that was published in General Dentistry: Challenging historical dogma: should you really have epinephrine autoinjectors in your emergency kit? (November 2016). He spoke with Dr. Chiraz Guessaier about issues related to autoinjectors and the essentials of the dental emergency kit.

Read the full article (PDF)

Highlights

• Hospitals, clinics, emergency responders, and even dental offices are beginning to question the historical dogma: Are epinephrine autoinjectors truly essential in emergency kits?
• There is general agreement among oral healthcare practitioners as to the essential medications in emergency medical kits: epinephrine, diphenhydramine, nitroglycerin, albuterol, glucose, aspirin, and oxygen. Furthermore, it is incumbent on all oral healthcare providers to keep up to date with the regulations of their licensing board regarding the specific emergency medications needed to remain compliant with the rules of the state or province in which they are licensed to practice.
• Since patient safety is always the primary concern, and the oaths of beneficence and non-maleficence that all dentists took upon graduation included “First, do no harm,” it is necessary to validate whether autoinjectors are really the safest dosage form to administer lifesaving epinephrine.
• Given the design challenges of all currently available epinephrine autoinjectors, the efficacy of these products is also being called into question.
• Since safety and efficacy concerns do not always make as eye-catching headlines as monumental price hikes, publicity has focused more on the geometric increase in price of these autoinjectors.
• There are many longstanding dogmas in medicine that deserve review as new data, techniques, devices, and evidence come to light.
• Based on current evidence, additional safety and efficacy concerns with this dosage form indicate that preparing your own anaphylaxis kit may be a better approach to keeping patients safe.