What is an adrenaline auto-injector?
An adrenaline auto-injector is the life-saving device we use to treat anaphylaxis. It is pre-loaded with the drug called adrenaline (also known as epinephrine internationally – epinephrine is mainly used in north America and Japan) into the bloodstream to reverse the effects of an allergic reaction. Adrenaline acts quickly to constrict blood vessels, relaxes the smooth muscles in the lungs to improve breathing, stimulate the heartbeat and helps stop swelling, including around the face and lips.
There are three brands of auto-injectors currently available in the UK called EpiPen, Jext and Emerade – currently under further investigation due to lack of needle firing. Although the instructions differ slightly, they do exactly the same job and treat anaphylactic symptoms and triggers within minutes.
The dose
The dose of adrenaline required is dependent on the person’s weight. A child will be prescribed a 0.15mg dose and when they reach 25kg (or 6 years old) it will be a 0.3mg dose pen. The medication is the same, it’s just double the dosage. Current resus council anaphylaxis algorithm also suggests 0.5mg (only used in Emerade) from 12 years or 50kg weight.
Storage of auto-injectors
It’s really important that auto-injectors are stored in a cool, dry place at room temperature (ideally 20 to 25 C). The mechanism in the auto-injector is affected when hot or near 0C temperatures. High temperatures can lead to adrenaline degrading.
A really good idea is to buy a suitable insulated medication bag to store them in. Don’t forget one for if your children are at school too so it’s kept safe for things like school trips. The one I would recommend is from Allerpacks (www.allerpacks.co.uk) where you can buy a variety of styles and colours to suit your needs.
To safely dispose of used or expired adrenaline auto-injectors, you can drop them at doctors, hospitals and some pharmacies. Never throw an auto-injector just in the bin.
Always carry two!
Anyone who has been prescribed adrenaline auto-injectors for allergies should carry two with them at all times in case of an emergency. The reason we need the two together is in case the persons symptoms get worse and they require a second dose or there was a problem with the first pen. Just a reminder that these should be carried with antihistamine to treat mild reactions and inhalers to treat asthma if you have it.
Spare pens for schools!
From 1st October 2017, the human medicines regulations 2017 has allowed schools to obtain, without prescription, adrenaline auto-injector (AAI) devices for use in emergencies.
Some key facts!
- Adrenaline Auto-injectors are single use only.
- You can inject them through clothing, just avoid any seams.
- You can use a second adrenaline auto-injector on someone experiencing anaphylaxis if their symptoms don’t improve after 5 minutes.
- If in doubt, administer! It’s a safe medication! It’s easier to reverse severe symptoms with early treatment.
- Remember to check the expiry date of your pen regularly.
Training!
Regular and correct training is really vital to ensure you’re up to date with any changes. You can order trainer pens from both the EpiPen and Jext pen website for free which I would highly recommend – you don’t want the first time you hold and use one to be in a life-threatening situation.
For more information on allergy awareness and adrenaline auto-injector training for schools, nurseries, parents and the hospitality sector, please visit www.theallergybadge.com
By Natalie Hopkins founder of The Allergy Badge & Dr José Maia e Costa MD FRCPCH Consultant Paediatrician in Allergy