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 Post subject: Epipen vs Twinject
PostPosted: Sat Apr 07, 2007 5:54 pm 
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Joined: Sat Sep 16, 2006 6:50 pm
Posts: 205
Location: Ontario, Canada
It has been recommended to me that we switch to Twinject. Can I get some feedback on Twinject users experiences -positive or negative? I'm not crazy about using a syringe.

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daughter: 6 years tree nuts, peanuts


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 Post subject:
PostPosted: Sat Apr 07, 2007 9:07 pm 
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Joined: Sat Apr 16, 2005 12:09 am
Posts: 1054
I carry Twinject for my son. The first dose is administered very similarly to an EpiPen. Instead of taking just the end cap off as on the EpiPen, with the Twinject you take the tip cap off and then the end cap off. From that point on, It's administered exactly the same as an EpiPen. When I used it on my son last summer, we got to hospital before a second dose would have been needed so I can't comment on using the syringe. For us, the decision was a matter of dollars and cents -- we don't have medical coverage and so we liked getting two doses for the price of one. Even if we never need the second dose, it's nice to know it's there (for the same price as one dose with EpiPen). I don't know if your child is school age or not, but there has been some discussion on the board about schools preferring EpiPen because they are familiar with it -- some talk about some schools banning Twinject (don't know if they can actually do that though?). I think what's most important is what you're comfortable with. Check out their website for more information http://www.twinject.ca/en/home.php -- get them to send you a free Twinject trainer http://www.twinject.ca/en/accessories.php and then go from there.


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 Post subject:
PostPosted: Sat Apr 07, 2007 10:17 pm 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
I'd just like to point out that the second dose in the twinject is pre-measured, and you don't need to get rid of air bubbles or anything. (Usually with a needle you do need to do that.)

I use the epi-pen because that is what our insurance covers. I prefer it for the school because all staff at my son's school is trained on it. When I discussed twinject with the principal, she said they would give only the first dose. (I think they could reasonably argue that the way the second dose is given goes against the teacher's contract. I agree that it does and would not be willing to argue with them on that. :) ) However, since I live in a major city, the ambulance should arrive before a second dose is required.

Also, I would still have to buy two twinjects for my son. His school wants him to carry one, and have one in an unlocked drawer in the office.

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self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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 Post subject:
PostPosted: Sun Apr 08, 2007 10:41 am 
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Joined: Sat Sep 16, 2006 6:50 pm
Posts: 205
Location: Ontario, Canada
I still keep an Epipen at my daughter's nursery school. As a teacher, I know we are only trained on Epipen. Maybe I will keep a twinject with me but Epi at school.

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daughter: 6 years tree nuts, peanuts


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 Post subject:
PostPosted: Mon Apr 09, 2007 2:40 pm 
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Joined: Sat Mar 05, 2005 7:06 pm
Posts: 39
Location: Winnipeg, MB, canada
I have used both multiple times. They are very similar and both very easy to use. If I had to rely on someone else administering the epi, I would prefer the epipen. As it looks easier to use. I am worried that people would freak out to much about looking and holding a syringe (from the twinject).
I carry 2 twinjects, as my last few reactions are needing a minimum of 3 shots of adrenaline to stop the reaction. But almost everytime I only needed to administer one shot as the ambulance arrives intime to administer the other shots. My last reaction I did need to administer the second shot of the twinject. I really don't remember it all that well, but I remember it being easy and fast.
I'm gonna start carrying the epipen again, so that if I do need someone else to administer they can pick which one they feel more comfortable with. As well, I like how the epipen is bigger and has a big yellow cap, so that it stands out and easy to see. I do not want life saving medication to be hidden away, or not easily seen.
Although with both, training is key!

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Anaphylactic to; fowl, fish and tree nuts
Idiopathic Anaphylaxis


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 Post subject:
PostPosted: Mon Apr 09, 2007 6:05 pm 
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Joined: Tue Jun 07, 2005 1:10 pm
Posts: 44
Location: Clarington
What I have found is it is nice to use both products. My teenage son likes the convenience of carrying only one Twinject around(two epipens in a pocket is bulky and the fanny pack is no longer cool) but the school is supplied with an Epipen for its simplicity in design and therefore use. Our experience is that staff are more comfortable with an auto injector as opposed to the exposed needle of the preloaded syringe. This way the person who is administering medication has options especially with regard to the second dose.

We needed to weigh compliance of our child carrying epinephrine with the wishes/comfort level of staff and economics. It has been great to have choices to suit everyone's wishes.


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 Post subject:
PostPosted: Mon Apr 09, 2007 11:11 pm 
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Joined: Tue Nov 29, 2005 4:04 pm
Posts: 2044
Location: Gatineau, Quebec
We do the same - we have Twinjects for home use and when we go out (with 2 kids it would be 4 EpiPens, so it's less bulky to have 2 Twinjects), and EpiPens for the school, as they seemed very nervous about the idea of having to use the Twinject. I would rather keep it simple for the school....

Some school boards do not allow the Twinject to be carried at all, while others will only allow the first dose to be given. Still others are fine with either auto-injector.

The CSACI has written a letter to all school boards in Canada suggesting that the decision should be left up to the allergist and the patient/family and not dictated by the school board. See http://www.csaci.ca/epinephrine_auto-injectors.htm for a copy of the letter. I do not know what effect this has had on any board's decision.

It is definitely a good idea to get a trainer and practice practice practice. I also agree that it is good for the allergic consumer to have options, and I for one am glad that both are available.

K.

_________________
Karen, proud Mom of
- DS1 (12 yrs): allergic to cashews, pistachios, Brazil nuts, potatoes, some legumes, some fish, pumpkin seeds; OAS
- DS2 (1o yrs): ana. to dairy, eggs, peanuts; asthma


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 Post subject:
PostPosted: Tue Apr 10, 2007 11:54 am 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
The previous link that I had to the Elemntary Teachers' Federation of Toronto collective agreement is no longer active. I am copying this from another forum, where it was posted when the link was active. (bold added by me)

Quote:
Under Working Conditions it states the following:

D.2.0. - MEDICAL PROCEDURES

D.2.1. No Teacher shall be required to carry out any of the following medical procedures: administer medication by injection, catheterization, tube feeding, feed students with impaired swallow reflex, postural drainage or manual expression of the bladder.

D.2.2. Except as may be required under law, no Teacher shall be required by the Board to examine/diagnose pupils for communicable conditions or diseases.

D.2.3. The Board shall not require, on a regular basis, any Teacher to administer, nor to perform any medical or physical procedure on a pupil except as defined in the Board protocol on the administration of medication.


We do need to keep in mind that teachers are people that chose to educate. It's unfortunate that we have to expect them to act as medical professionals as well -- but in a limited way that's exactly what we are expecting of them. I suppose we could fight to have nurses on staff, but that's a double-edged sword. Right now, whatever adult is near my son can give him is epi. If there's a nurse, probably it will be a limited number of people that can give it. Also, the board cannot afford to put a full time nurse in every school, and what value is a part-time nurse when you are talking about emergency medical treatment.

I would object if the school didn't allow the twinject to be carried at all. But, I support the decision to only give the first dose from it.

I am also glad to have a choice. And, I don't think it's just coincidence that there were improvements made in the epi-pen at the time the twinject became available. Free enterprise does have it's benefits. ;)

_________________
self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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 Post subject:
PostPosted: Tue Apr 10, 2007 6:23 pm 
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Joined: Thu Sep 22, 2005 11:39 pm
Posts: 1141
Location: saskatchewan, canada
Quote:
We do need to keep in mind that teachers are people that chose to educate. It's unfortunate that we have to expect them to act as medical professionals as well



Keep in mind, children are legally required to attend school (unless their parents are legally homeschooling). It's only fair to expect basic medical services for kids who need it once they get there. Personally, I feel if schools are going to be responsible for children all day...then they need to be responsible for ALL children...not just the ones lucky enough to not have health problems. Yes, they may have "chosen to educate", but a profession where one is responsible for kids all day, in an "all inclusive" public school, should imply basic medical supervision for those who need it. That's just reality...not all kids are 100% healthy 100% of the time.

_________________
DD age 9 1/2 -peanuts, nuts,
DD age 7 1/2 - milk, eggs, chicken, peanuts, treenuts, cats, dogs,
DS age 2 1/2
Husband- asthma, eggs, treenuts, fish, shellfish environmental
Self - penicillan, eurithromiacin, mild laytex allergy.


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 Post subject:
PostPosted: Wed Apr 11, 2007 1:56 pm 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
Do you also feel teachers should be responsible for tube feeding? postural drainage? manual expression of the bladder? These are things that other children require -- and if teacher's did it, they could attend school. But, would you agree with me that those are things that are above and beyond what should be expected of a teacher?

Twenty years ago, no teacher would have been expected to give an injection as part of basic medical services. But, with the increase in allergies this has become a necessity. And fortunately, with the auto-injector it can be done quickly, with very limited training, and with very little risk to those administering it. (Injecting with a standard type needle is more difficult, and there is some risk that you will inject yourself it you don't know what you are doing.) I just (personally) feel that it's unfortunate this needs to be required of teachers, though I agree it is required. And I (personally) feel expecting them to also use something that is not completely auto-injectible is unreasonable if they are not comfortable with it.

_________________
self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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 Post subject:
PostPosted: Wed Apr 11, 2007 3:43 pm 
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Joined: Thu Sep 22, 2005 11:39 pm
Posts: 1141
Location: saskatchewan, canada
Quote:
Do you also feel teachers should be responsible for tube feeding? postural drainage? manual expression of the bladder? These are things that other children require -- and if teacher's did it, they could attend school. But, would you agree with me that those are things that are above and beyond what should be expected of a teacher?


Keeping kids alive and healthy while attending school needs to be SOMEONES job. I've heard of MANY other people lately who have also chosen homeschooling because their schools will not provide reasonable care for their kids non-allergy health conditions either. What happens to kids who have health conditions who do not have parents willing/able/capable of teaching them at home? Do they just go to public school and hope for the best because no one is willing to step up to the plate and help that kid stay healthy throughout the day? Who will tube feed that child... or will they starve...(sorry don't know exactly what postural drainage is)... who will manually express that childs bladder so their bladder does not burst? Anyone???

Administering a second dose on a twinject should be an unlikely scenerio anyways, one would like to think an ambulance would arrive before that is required...BUT what if the ambulance gets in an accident on the way to the school...or you're in an emergancy situation due to extreme weather? Do you just watch the kid die because "it's not required by your contract"? One would like to think that who ever the adult in charge is would feel fortunate to have that second dose.

Quote:
Twenty years ago, no teacher would have been expected to give an injection as part of basic medical services.


Twenty years ago my husband attended school with severe allergies. He was not safe at school then either (no epipen)...but...the school was not full of snack/party/junk food, and his classrooms were not lunchrooms. Lots of kids went home for lunch, or ate in a lunchroom so there was limited food in his school.

_________________
DD age 9 1/2 -peanuts, nuts,
DD age 7 1/2 - milk, eggs, chicken, peanuts, treenuts, cats, dogs,
DS age 2 1/2
Husband- asthma, eggs, treenuts, fish, shellfish environmental
Self - penicillan, eurithromiacin, mild laytex allergy.


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 Post subject:
PostPosted: Wed Apr 11, 2007 4:21 pm 
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Joined: Wed Aug 10, 2005 11:21 am
Posts: 687
Location: Cobourg, ON
Just to pass along information. Children who require catheters (spelling?) or other regular medical treatment receive EA support here in Ontario. Last year I had a child in my class who was tube fed in addition to many other medical issues and she had an EA and a nurse with her at all times. School boards are allotted money for EA's to assist for medical needs. A great deal of supporting documentation is required to receive support. Need has to be demonstrated and a diagnosis from a doctor is required.

I think most teachers would use the Twinject in an emergency even if they are directed by contract not to. I couldn't imagine letting a child die in front of me. I was wondering if 911 operators could talk someone unfamiliar with a Twinject through the process? I wonder if they have any training in this area.

_________________
13 year old daughter -- lives with life-threatening allergies to milk, tree nuts and peanuts; seasonal allergies (birch, maple, ragweed); pet allergies; asthma; and eczema
10 year old son - no allergies


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 Post subject:
PostPosted: Wed Apr 11, 2007 5:33 pm 
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Joined: Sat Sep 16, 2006 6:50 pm
Posts: 205
Location: Ontario, Canada
I agree with you Katec. I think most teachers ( or someone at the school) would use the second syringe if necessary. However, I just received my twinject trainer today and I am still not comfortable with it. Caring for a severely allergic child is a big responsability and if a school would feel more comfortable with an Epipen, I have absolutely no problem with that.

_________________
daughter: 6 years tree nuts, peanuts


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 Post subject:
PostPosted: Thu Apr 12, 2007 11:01 am 
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Joined: Tue Jun 07, 2005 1:10 pm
Posts: 44
Location: Clarington
Does anyone know if teachers are expected to administer insulin via syringe should a diabetic student should require it(and the student is unable to administer it him/her self)? If the answer is yes, then what is the difference with that scenario and the second dose of the twinject?


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 Post subject:
PostPosted: Thu Apr 12, 2007 1:17 pm 
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Joined: Thu Mar 03, 2005 9:38 pm
Posts: 1643
Location: Toronto
My son's school insists on two pens. Whether they are epi-pen or twin-ject is not important. One the child wears/carries, and one is kept (unlocked) in the office. In the unlikely event a second shot is needed, it's available. (Also, the school has one that they provide that is also kept in the office.)


So, saskmommy, while I agree the school has to be prepared, willing, and able to provide the care, I also feel that we as parents need to pay attention when they have concerns/objections and work together with them. It's the same medicine in either container. I don't see the value in fighting over which one is administered.

Anyway, I'm going to back out of this thread. I seem to be upsetting you. (Maybe it's the tone I'm reading in, not the tone you are writing in -- can never really tell. Either way, I'm not interested in upsetting anyone. :) )

_________________
self: allergy to sesame seeds and peanuts
3 sons each with at least one of the following allergies: peniciilin, sulfa-based antibiotic, latex, insect bites/stings


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