Epinephrine Auto-injectors: Is Needle Length Adequate for Delivery of Epinephrine Intramuscularly?

Stecher, Dawn S.; Bulloch, Blake; Sales, Justin; Schaefer, Carrie M; Keahey, Laine

doi:10.1542/peds.2008-3388

Cited by 71 publications

(53 citation statements)

References 11 publications

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“…As important, when drug manufacturers package needles with IM injectable medication, they must guide practice by providing appropriately sized needles according to various BMIs or weights of patients. [19,43] …”

Section: Reporting Of Methodological Datamentioning

confidence: 99%

“…The typical needles used in these injectors are often too short to reach muscle in heavier populations, including women and children. [11,29] Manufacturers recommending or providing appropriately sized needles to reach the target tissue is important to ensure efficacy of the medications and vaccines.…”

Section: Injection Depthmentioning

confidence: 99%

“…[2,11,13,43] Continuous education based on current evidence is vital to providing safe quality care.…”

Section: Practice Variationmentioning

confidence: 99%

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Evidence calls for practice change in intramuscular injection techniques

Strohfus

Paugh²,

Tindell³

et al. 2017

JNEP

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Background and Objective: Intramuscular (IM) injections are administered to patients in all health care settings. Even though this procedure is invasive and the evidence supporting the process of administration is extensive, techniques and procedures vary throughout the literature and in practice. The purpose of this descriptive correlational study was to 1) investigate the literature on current evidence-based IM injection procedures pertaining to gender, patient weight, injection site, needle length, and technique, 2) compare surveyed healthcare personnel self-reported IM injection practices, and 3) query respondents on informational resources they access, continuing education they receive, and their years of healthcare experience and higher education. Methods: The Intramuscular Injection Questionnaire (IIQ) was sent via email to various professional healthcare facilities and their respective social media sites. Two hundred and six (206) healthcare personnel of various healthcare backgrounds and educational levels accessed the IIQ via a link to Qualtrics software. SPSS Version 24 was used for data analysis. Results: Most respondents were registered nurses with 4 -15+ years of experience. Seventy-eight percent of respondents considered their IM injection knowledge at above average or expert levels. Gender was not considered an important factor when selecting an injection needle among 75% of participants. Of all respondents, 61% use z-track technique, 59% use the ventrogluteal site and 34% always bunch or stretch the skin during injection. IM injection education was not provided in 75% of healthcare facilities. Conclusions: IM injection practices vary among respondents and in the literature; some reported practices are contrary to current evidence-based practice. While the evidence provides some sound recommendations, some procedures are not well-documented or supported including in nursing texts. Nurses and other healthcare personnel must critically analyze the site, depth, needle, volume, medication, vaccine, and whether to bunch or stretch, according to evidence-based practice. Healthcare facilities should provide IM injection education routinely to ensure safe practices. Future studies (Level 1 and 2) are needed to further demonstrate the best evidence leading to safe and effective IM injections.

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Section: Reporting Of Methodological Datamentioning

confidence: 99%

Section: Injection Depthmentioning

confidence: 99%

See 1 more Smart Citation

Evidence calls for practice change in intramuscular injection techniques

Strohfus

Paugh²,

Tindell³

et al. 2017

JNEP

View full text Add to dashboard Cite

show abstract

“…[11][12][13][14][15][16][17][18] Studies in adult have shown the inadequacy of the epinephrine auto-injector needle length especially in women.…”

Section: Discussionmentioning

confidence: 99%

Needle length for epinephrine prefilled syringes in children and adolescents: Is it one inch?

Manuyakorn

Bamrungchaowkasem

Ruangwattanapaisarn

et al. 2017

Asian Pac J Allergy Immunol

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“…During an anaphylactic emergency, not only it is important that adrenaline is administered into the correct tissue compartment [15,16] but also that the correct dose of adrenaline is administered to achieve the desired clinical benefit.…”

mentioning

confidence: 99%

Self-Injectable Adrenaline for Anaphylactic Emergencies: Effectiveness of Epipen and Anapen - Are they Fit for Purpose - Evidence to Date

Simon¹,

Ram²

2012

J Aller Ther

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Epinephrine Auto-injectors: Is Needle Length Adequate for Delivery of Epinephrine Intramuscularly?

Abstract: The needle on epinephrine auto-injectors is not long enough to reach the muscle in a significant number of children. Increasing the needle length on the auto-injectors would increase the likelihood that more children receive epinephrine by the recommended intramuscular route.

Cited by 71 publications

References 11 publications

Evidence calls for practice change in intramuscular injection techniques

Evidence calls for practice change in intramuscular injection techniques

Needle length for epinephrine prefilled syringes in children and adolescents: Is it one inch?

Self-Injectable Adrenaline for Anaphylactic Emergencies: Effectiveness of Epipen and Anapen - Are they Fit for Purpose - Evidence to Date

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