Let’s just say that her quick action with a customer suffering from anaphylactic shock on Dec. 26 was probably the best belated Christmas present he ever received.
Von Flatern, who earned her doctor of pharmacy degree from URI in May 2014, has been working at the Cape Cod pharmacy since she graduated.
“The day after Christmas was a quiet day initially,” Von Flatern said. “But then one of my staff members was helping a customer at the drive-through window, and I could hear the urgency in her voice as he told her he was in anaphylactic shock.”
Von Flatern, who grew up in Sunderland Mass., said the customer was asking for an EpiPen, an auto-injector that provides a dose of epinephrine, a medication that treats life-threatening allergic reactions.
EpiPens are not sold over the counter, so right after Von Flatern pulled one from her area, she entered the customer’s name in the computer to research potential drug interactions. She opened the package, and handed the device out the drive-through window.
“I could see that his skin was red, his lips and face were swollen, and I asked him if he wanted me to administer it to him, and he said yes. I could see he was struggling, and then I saw the relief in his face when I told him I would help.”
Things happened fast and simultaneously. Von Flatern hopped on the counter, wiggled her way through the drive-through window and onto the parking lot, since that was the fastest way to get to him. As she administered the EpiPen, a staff member called 911. He was taken by ambulance to the hospital where he recovered fully and was later sent home.
“He came in a day later to say thanks, but I had already completed my shift and gone home. I actually saw him later, and he was very grateful.”
Von Flatern said he may have used soap at work that had nuts in it, and he was allergic to nuts. He had an EpiPen at home, but not at work.
The first-year pharmacist credits her URI education with preparing her for such emergencies.
“URI isn’t just interested in us learning theory from textbooks,” said Von Flatern, who received a congratulatory letter from CVS corporate offices for her actions. “URI really focuses on the people we will be serving.”
She said she and her classmates are taught they are someday going to have to respond well to emergencies.
“We know we are going to have to talk with them about side effects of drugs. We are in the community, hospitals and clinics dealing with real patients and real problems.”
Von Flatern was fortunate that one of her pharmacy rotations was teaching patient assessment with Celia MacDonnell, clinical professor of pharmacy, and Anita Jackson, clinical assistant professor of pharmacy.
“We covered anaphylactic shock, but Dr. MacDonnell even asked us, ‘What do you do for a snake bite victim, or for someone having a seizure?’ We covered a wide range of emergencies in that class.”
At her pharmacy on that day in December, everything happened fast, and she had to confront this question in seconds, “What do you do?”
“Basically your choice is whether to act or not, and given our URI pharmacy education, I would say that my peers and I would act because we are prepared.”
MacDonnell said she taught Von Flatern for a full year in a laboratory class and then worked with her in the advanced clinical practice rotation for six weeks.
MacDonnell said all doctor of pharmacy students have to learn cardiopulmonary resuscitation and first aid. They work in a practice lab in small groups making presentations on how to handle such emergencies as choking, someone breaking a bone on a hike and bee stings. The class teaches them how to use EpiPens with placebos.
“Kristin was always very focused, very mature and always posed good questions,” MacDonnell said. “She just had a desire to not be just a prescription dispenser. She wanted to be a pharmacist who would help people. She wanted to be the one who had the answers.”
“And now, I am going to tell this story in my class, because the students will hold on to this and know they can make a difference too,” MacDonnell said.