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In many circumstances, pharmacists are not allowed to administer an epinephrine injection unless the patient presents a prescription.
In many circumstances, pharmacists are not allowed to administer an epinephrine injection (EpiPen) unless the patient presents a prescription. However, one patient is doling out praise for a pharmacist who recently provided an EpiPen without a prescription while he was experiencing anaphylactic shock.
A chef in Northern Island named Aaron McDonald was having lunch one Saturday afternoon when he realized that the stuffing he was eating contained traces of nuts. Within seconds, McDonald felt as though his throat had closed, The Belfast Telegraph reported.
He was diagnosed with an “aggressive” nut allergy in 2006 and knew that he was supposed to carry an EpiPen with him at all times. In similar situations in the past, McDonald has always had an EpiPen with him, but this time, panic swept over him as he realized he didn’t have one.
“My face, throat, tongue, and lips were starting to swell up to the point where my breathing was becoming extremely difficult,” McDonald told The Belfast Telegraph. “I knew if I didn't get treated, the symptoms would kill me."
He left the restaurant and ran to McNally’s Late Night Pharmacy, where a newly graduated pharmacist named Noelle Holmes was working.
"Noelle was just brilliant,” McDonald told The Belfast Telegraph. “She knew it was a life or death situation.”
Even though Holmes was not technically supposed to dispense an EpiPen without a prescription or counseling, McDonald said he felt lucky that Holmes decided it was more important to get him treated. By that point, McDonald was barely breathing.
Holmes called the police after handing over an EpiPen, and McDonald was taken to a local hospital.
“The medical team told her that she had done the right thing in not waiting to give me the shot,” McDonald told The Belfast Telegraph. “I am so thankful to all the staff…They saved my life, especially Noelle, and it is important that I raise awareness of what happened.”
McDonald added that he hopes to advocate for pharmacists to be able to provide EpiPens without prescriptions.
In 2013, a 14-year-old girl with nut allergies died in Dublin after consuming a peanut-based sauce, The Irish Times reported. The girl’s mother, Caroline Sloan, reportedly stopped into a pharmacy and said “someone she was with” had eaten satay sauce and needed an EpiPen.
The pharmacist told her to call an ambulance, but the mother later disputed this fact.
After the girl’s death, the pharmacist was investigated by Pharmaceutical Society of Ireland, but the case was dismissed because of discrepancies in the mother’s statements and because the pharmacist had instructed the mother to get an ambulance.
The pharmacy allegedly received death threats after the incident, The Irish Times reported.
In another case, a woman experienced a serious allergic reaction to a bee sting and went to the pharmacy for help. The pharmacist administered epinephrine and then convinced the woman that she still needed to go to the hospital despite her initial reluctance.
In the ambulance, the woman’s symptoms returned more aggressively and she had a biphasic reaction, but the medical staff was able to treat her secondary reaction quickly.
Pharmacists can serve patients with allergies by informing them of possible symptoms and reactions and by teaching patients and their loved ones about how to use epinephrine auto-injectors.