Wednesday, August 23, 2017
One assumption many people make is that if they learn CPR, they will be able to perform it when the opportunity presents itself.
But that's not always the case.
According to Bob Trenkamp, President of slicc.org: "the amount of force required to compress a human chest to a two-inch depth depends upon the stiffness of the victim's chest."
A rescuer's ability to compress that chest depends upon the rescuer's weight and weight distribution, and the method of compression used (hand or heel). Those who were taught to crunch their abdominal muscles during the down-stroke can generate some additional force, but I've never seen anybody be able to do that for more than two minutes."
The average adult chest stiffness requires 130 pounds to get a two-inch compression. The average rescuer has to weigh somewhere about 25% more than the victim's chest stiffness, if performing compression manually - a bit less if performing compression with the heel of the foot - to get a two-inch depth.
About 70% of all cardiac arrests occur in a private residence. Two-thirds of arrest victims are male. A study by Trenkamp and Perez presented at the AHA Q-COR conference in Alexandria, VA in the spring of 2017 suggested that the percentage of all homes with two adults where each adult could perform a single two-inch compression on the other was zero percent. The cohort was assembled from zip code 31411. Households responding with data for only one person were excluded. The age distribution was significantly biased toward people in their 70's, probably due to (a) where the sample was recruited, and (b) people who took the time to fill out the response and return it.
By this point in the discussion, someone has usually said "But ANY CPR is better than no CPR!" Let me offer two other considerations: (1) with sufficiently shallower than guideline compression depth, there is an enhanced chance that the after the heart is re-started, the victim will not be able to handle the activities of daily living without assistance. (2) Dr. Vadebancoeur et al in Resuscitation 84 (2014) 182-188 reported on chest compression depth and survival in 593 out-of-hospital cardiac arrests. The survivors received 2.11 inch depth compression, on the average. The non-survivors received 1.92 inch depth compressions.
Bob Trenkamp, President
Saving Lives In Chatham County
Saving Lives In Chatham County
Sunday, March 12, 2017
The EpiPen Alternative That Saves You Hundreds of Dollars
If you suffer from severe allergies, or have a family member who does, you’re probably already outraged by the high cost of the EpiPen.
But what if we told you that you could get an EpiPen alternative (known as generic Adrenaclick) for as little as $10 for a two-pack – even if you don’t have insurance?
In fact, you may even be eligible for free EpiPen alternatives – depending on your insurance and manufacturer coupons – like a generic EpiPen or AUVI-Q.
It’s time you got the lifesaving allergy protection you need at an affordable price. Read on for the details:
Why Are EpiPens So Expensive?
Over the past several years, the creator of the original EpiPen – a company called Mylan Pharmaceuticals – has been steadily increasing the price of this lifesaving medication.
Even people with health insurance were facing price tags of $600 or more for a two-pack of injectors. And the controversy reached a boiling point last summer, when parents were shocked by the suddenly unaffordable cost of purchasing back-to-school EpiPens for their children.
Public outrage was so strong that Mylan began offering discount coupons, cutting the price of a two-pack down as low as $300. Even so, this was too expensive for many families – especially those who needed multiple packs to keep at home, with the school nurse, and with the supervisors at their children’s extracurricular activities.
What Are Your Options?
Think you’re at the mercy of the pharmaceutical companies and their ever-rising prices? Think again. We’ve put together a list of your best options for epinephrine injectors, and some ways to seriously slash the price tags.
Adrenaclick (generic): $10 at CVS
Right up until Fall 2016, Adrenaclick was EpiPen’s only competitor. The company uses the exact same active medication (the hormone known as epinephrine) and a similar injector mechanism for delivery, but priced their two-packs at just under $300.
That price tag is already more appealing than the EpiPen, but it gets even better. In January 2017, CVS struck a deal to offer generic Adrenaclick at $110 for a two-pack. Combine that with a $100 discount coupon from the manufacturer, and you’re looking at a mere $10 for your lifesaving medicine.
What’s more, you don’t need insurance to take advantage of these rates. In fact, you cannot use the coupon in combination with Medicare/Medicaid or other federal/state insurances. If you are covered under one of these plans, just ask the pharmacist not to run the purchase through your insurance provider. The coupon can also be used in tandem with commercial insurance to lower your co-pay at other pharmacies.
If you are thinking of making the switch from the EpiPen to Adrenaclick, it’s important to note that using the injector will be a little different than you’re used to. Be sure to ask your pharmacist for a quick training session before you go. You can also reference this training video on the manufacturer’s website.
EpiPen (both branded and generic): $300 – $630 (or less with insurance)
After the public outcry about their high pricing, Mylan introduced a generic version of their signature EpiPen alongside the branded version – coming in at $300 for a two-pack.
There is effectively no difference between the generic and branded EpiPens, aside from the fact that your insurance may only cover one or the other. If you are on a commercial health insurance plan, a $25 discount coupon could lower your co-pay to as little as $0.
So is there any reason to still choose the EpiPen over the ultra-affordable generic Adrenaclick? Only in certain circumstances:
- If your insurance specifically covers only the EpiPen, and you can utilize a manufacturer co-pay coupon to get your out-of-pocket costs close to zero.
- If you can qualify for free EpiPens through Mylan’s patient assistance program for uninsured/underinsured patients with a limited household income.
Auvi-Q: $360 (or less with insurance)
The Auvi-Q auto-injector is particularly interesting for having voice prompts to help you use it correctly. It first hit the market in 2013, but was recalled by manufacturer Kaleo in 2015 over some potentially dangerous problems relating to dosing.
A new and improved version of the Auvi-Q injector returned to pharmacies nationwide last month, now priced at around $360 for a two-pack. The injector has the advantage of being easy to use, especially for children, and requires no special training.
What’s more, Kaleo offers a discount program to reduce your co-pay to as little as $0 – even if your commercial insurance doesn’t cover the Auvi-Q. Note that those without insurance, or with Medicare/Medicaid or other federal/state insurance, are not eligible for this program – though the uninsured may qualify for free medication through Kaleo’s patient assistance program, depending on their household income.