Memo to EMS Agencies in Regards to Syringe Epinephrine Recall

A memo to EMS Agencies in regards to the U.S. Food and Drug Administration’s syringe epinephrine recall:

TO: All EMS Agencies with Syringe Epinephrine Kits (aka Check & Inject Kits)

Date: 12/19/18

FROM: North Country Regional Advisory Committee

RE: Epi-safe syringes

  • FDA recalled the epi-safe syringes because they consider the “A” and “P” marking to be an off-label use.
  • There is no change to the dosing of epinephrine under NYS protocol.
  • Bound Tree Medical is sending all agencies that have ordered kits from them new standard 1 cc syringes that do not have the markings.
  • NCEMS REMAC medical director has approved the continued use of the epi-safe syringes as they are the same dose that is currently contained in epi-pens and correspond with NYS BLS protocol.

Please consult with your medical director as to which of the following actions your agency should proceed with:

  • Train all providers on using a standard 1 cc syringe- All training must be documented and on file at the agency.
  • If the syringes in the kit are not expired but the epinephrine (adrenaline) is expired, you may replace the epinephrine (adrenaline) only. – make sure the new expiration date is noted on the kit.
  • Purchase epi-pens in place of the kits- there are cheaper versions available now.

The REMAC will continue to track this issue and notify agencies if any changes develop. At this time, we do not believe that the epi-safe syringes are going to be available so that when your current supply runs out or is expired you will have to either purchase epi-pens or train all your providers on using a standard 1 cc syringe.

For more information, contact the North Country EMS Program Agency at (315) 755-2020 ext. 56.


North Country Regional Emergency Medical Advisory Committee

Serving Jefferson, Lewis & St. Lawrence counties

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