An emergency drug kit should be designed to help stabilize a patient experiencing an acute medical emergency. Dentists are not expected to provide long-term definitive care any more than I am expected to perform a root canal. However, the public expects you to have the means and know how to keep them alive until EMS arrives.
There are a multitude of prepackaged medication kits that are so called “customized” for a dental office. Medications expire and must be replaced on a regular basis. Most medications are very expensive to maintain simply because of how they are packaged. Keeping your kit simple and learning how to give simple injections can save you hundreds of dollars every year.
For example, look at epinephrine. Most dentists have one dose of 1:10,000 concentration epinephrine preloaded in an adult EpiPen. If they see pediatric patients, they have a second EpiJr. which simply contains a smaller dosage. The advantage: Premeasured dosing, ready to inject into someone’s thigh—right through his/her Levis. The downside: Each EpiPen costs about $150 to replace. From a patient care perspective, the EpiJr. is an attempt to standardize a dose that really should be calculated for each individual child.
With less than a half-hour of training (and my proprietary, easy to use chart), you can learn how to easily calculate dosages, draw the epinephrine 1:1000 concentration up from an ampoule, and give a subcutaneous injection. By calculating your own dosages and drawing up the medication, you eliminate the need for two separate prepackaged items. The cost of replacing an epinephrine ampoule is about $10, saving you about $290.
Another example might be the albuterol metered dose inhaler (MDI). I am intrigued that every commercially prepared drug kit that I have seen has one of these. The advantage: MDIs are simple to use in principle and familiar to patients with asthma. The downside: The MDI was never intended for use in a clinical setting, nor is it as effective as nebulized albuterol. For sanitary reasons the MDI must be replaced after use on a single patient. The cost of replacement is around $70.
With less than 15 minutes of training, you can learn how to assemble an albuterol nebulizer. The cost of replacing a nebulized albuterol dose is less than $15, saving you about $55.
A third example is nitroglycerine. Some kits come with a nitroglycerine spray. The advantage: The medication in the spray bottle is not exposed to the air, so it keeps its potency even after a single use. Nitroglycerine tablets must be replaced within a month of opening its bottle. The downside: Replacing the spray pump costs about $100.
With no additional training, you can replace nitroglycerine spray with nitroglycerine tablets. Replacing a bottle of tablets costs about $20, saving you about $80.
Many emergency drug kits are marketed to dentists as being “customized”. Really, the customization is just in the packaging that costs significantly more money to replace in the end. With less than an hour of training, you can significantly reduce your expenses when it comes time to replace expired medications.
-Erik Zalewski, M.S., EMT-CC
CEO of Have Dummy Will Travel, Inc.