Brief CommunicationEpinephrine for the out-of-hospital (first-aid) treatment of anaphylaxis in infants: Is the ampule/syringe/needle method practical?☆,☆☆
Section snippets
Methods
This project was reviewed by the Research Ethics Board of the University of Manitoba. The study was performed at the Children's Hospital/Health Sciences Center and the John Buhler Research Center, Winnipeg, Manitoba, Canada.
Results
Eighteen parents of children at risk for anaphylaxis agreed to take part in the project, as did 18 pediatric resident controls, 18 general duty nurse controls, and 18 emergency department nurse controls. All 72 participants completed the study.
In contrast to the health care professionals, all of whom demonstrated the correct technique for opening the glass ampule, drawing up the epinephrine into the syringe, and removing the air from the syringe, 3 of 18 parents struggled to open the ampule and
Discussion
The available options for administration of an accurate epinephrine dose to infants experiencing anaphylaxis outside the hospital setting vary considerably in ease of use and in cost, and each has advantages and disadvantages.
The EpiPen Jr and EpiPen auto-injectors currently represent the most user-friendly method of giving an epinephrine injection, but they are also associated with the greatest expense ($50.00 US or more for a single dose) and are not available in many countries. They have the
Acknowledgements
We acknowledge the support of Wade T. A. Watson, MD, FRCPC, and the Allergy nurses, Lana M. Johnston, RN, Cathy A. Gillespie, RN, BA, Fay Ernst, RN, and Carolyn Kosowan, RN.
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2022, Immunology and Allergy Clinics of North AmericaCitation Excerpt :The reason is that an epinephrine ampule or vial with an empty syringe requires more skill to properly draw up the epinephrine and administer it under emergency circumstances. Parents of individuals with a history of a SAR take longer to draw up epinephrine from an ampule (average 142 ± 13 seconds) compared with emergency department nurses (29 ± 0.09 seconds; P < .05).44 The epinephrine dose drawn up by parents also ranged 40-fold when compared with 2-fold for emergency department nurses.44
Recognition and treatment of anaphylaxis
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Supported by the Children's Hospital Foundation of Manitoba, Inc. No financial or in-kind support was provided by any corporate sponsor.
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Reprint requests: F.E.R. Simons, MD, FRCPC, 820 Sherbrook Street, Winnipeg, Manitoba, Canada R3A 1R9.