A simple method to improve safety of epinephrine auto‐injectors

Kränke, Birger; Schuster, Christian; Wiednig, Michaela; Reiter, Harald

doi:10.1111/j.1399-3038.2012.01299.x

Cited by 5 publications

(4 citation statements)

References 8 publications

(9 reference statements)

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“…A common finding in the analysis of registries and observational studies is that AAI is used only in a minority of cases of anaphylaxis, implying that not only education of patients and families but also of school staff and HCP is highly needed. In a Dutch study , only a small proportion of food‐allergic teenagers at risk of anaphylaxis were prescribed an AAI.…”

Section: Anaphylaxismentioning

confidence: 99%

Food allergy and anaphylaxis in pediatrics: update 2010‐2012

Santos

Lack

2012

Pediatric Allergy Immunology

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This review highlights the progress made in food allergy (FA) and anaphylaxis research in pediatrics published in the journal Pediatric Allergy and Immunology since 2010. Putative risk factors for FA are as follows: a family history of allergic disease, particularly in the mother, low birth order, season of birth, and severe atopic eczema. Obstetric practices, antibiotic use, and home environment are factors deserving further research. Diagnostic decision levels and component-specific IgE are useful in the diagnosis of FA; however, oral food challenges remain the gold standard and may also be a means to reduce parental anxiety and to improve education. Oral immunotherapy studies show promise in increasing the threshold of reactivity of allergic patients and therefore improving their quality of life. In single-nut-allergic patients, introduction of other nuts allows broadening the diet and thus reducing the psychological impact of allergen avoidance. Nutritional deficiencies are not uncommon in food-allergic children and should be specifically assessed. The prescription of injectable adrenaline is still insufficient and not consistent among practitioners, requiring improved training and implementation of guidelines. Current research into the epidemiology and immunological mechanisms of FA and tolerance will enable us to devise strategies to both prevent and treat food allergies.

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Section: Anaphylaxismentioning

confidence: 99%

Food allergy and anaphylaxis in pediatrics: update 2010‐2012

Santos

Lack

2012

Pediatric Allergy Immunology

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“…The ergonomics of the EpiPen has attracted some concerns in the past [12]. Upside-down use of EpiPen devices resulting in thumb injections as well as failed drug administration has been frequently reported.…”

Section: Discussionmentioning

confidence: 99%

Hooked epinephrine auto-injector devices in children: four case reports with three different proposed mechanisms

Goldman¹,

Long²,

Brown³

2020

Allergy Asthma Clin Immunol

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Background: The prevalence of epinephrine auto-injectors (EAI) use is on the rise. Our objective was to describes children with hooked EAI needles that were embedded in soft tissues. Case presentation: Results: Two children self-injected in their shins. The embedded EAIs required removal in the Emergency Department. Both needles were hooked and splayed at the tip. A boy in anaphylaxis kicked his leg during EAI injection and the hooked needle embedded under his skin and was difficult to dislodge. The exposed needle was curved. A girl had an EAI administered for anaphylaxis, which was also difficult to dislodge. On removal, the distal needle tip was hooked approximately 160 degrees. Images of the device revealed that the needle fired off-center from the device and the device components were cracked. We propose three different explanations for these hooked EAI needles. The first is that the needle could hit bone during injection and curve rather than penetrates further. Secondly, the needle could bend when the patient moves during injection. Thirdly, if a needle fires sufficiently offcenter to hit the cartridge carrier, this could hook the needle prior to injection. Conclusions: Awareness of the reasons for needle hooking, damage observed, and challenges and successful approaches to their removal, can better prepare the provider for these uncommon events. Teaching parents, children and educators about safe EAI storage and appropriate restraint during use may prevent some of these accidental injuries. Reporting device failures may lead to improvements in device performance and design.

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“…The alternative method of ‘ Press and Push Firmly ’ involves gripping the EpiPen in the carer's hand, placing the orange tip against the outer thigh at a right angle in a controlled manner, pressing down and pushing firmly until the EpiPen fires 5 6. This technique is likely to reduce laceration risk and is recommended by the Australasian Society of Clinical Immunology and Allergy 5 6…”

mentioning

confidence: 99%

“…This technique is likely to reduce laceration risk and is recommended by the Australasian Society of Clinical Immunology and Allergy 5 6…”

mentioning

confidence: 99%