The Medicines and Healthcare Products Regulatory Agency (MHRA) has issued guidance for the prescribing and use of adrenaline auto-injectors.
In summary: People who have been prescribed an Adrenaline Auto-Injector (AAI) because of the risk of anaphylaxis should carry two with them at all times for emergency on the spot use. After every use of an adrenaline auto-injector, an ambulance should be called (even if symptoms are improving), the individual should lie down with their legs raised and, if at all possible, should not be left alone.
The Anaphylaxis Campaign welcomes this statement from the MHRA. We actively campaign for people to be prescribed two AAIs and firmly recommend that once prescribed they should always be kept with the patient so they have access to them at all times. The reasoning behind two devices always being available is in case one is broken or misfires, or a second injection is needed before emergency help arrives.
We also provide specialised training for patients/carers and healthcare professionals via our AllergyWise online courses.
The MHRA’s advice also includes the following key points;
Advice for people with allergies and their carers:
- Carry two adrenaline auto-injectors at all times. This is particularly important for people who also have allergic asthma as they are at increased risk of a severe anaphylactic reaction
- Use the adrenaline auto-injector at the first signs of a severe allergic reaction
- Take the following actions immediately after every use of an adrenaline auto-injector:
– Call 999, ask for an ambulance and state “anaphylaxis”, even if symptoms are improving.
– Lie flat with the legs raised in order to maintain blood flow. If you have breathing difficulties sit up to make breathing easier.
– Seek help immediately after using the auto-injector and if at all possible stay with the person while waiting for the ambulance.
– If the person does not start to feel better, the second auto-injector should be used 5 to 15 minutes after the first
– Check the expiry date of the adrenaline auto-injectors and obtain replacements before they expire. Expired injectors will be less effective.
Advice for healthcare professionals:
- Ensure that people with allergies and their carers have been trained to use the particular auto-injector that they have been prescribed. Injection technique varies between injectors.
- Encourage people with allergies and their carers to obtain and practise using a trainer device (available for free from the manufacturers’ websites).
Trainer Devices:
- To order an EpiPen trainer device, visit: http://www.epipen.co.uk/patients/myepipenr-resources/
- To order a Jext trainer device, visit: https://adults.jext.co.uk/resources/
- To order an Emerade trainer device, visit: https://www.emeradebausch.co.uk/patient/order-trainer-pens
- Emerade devices in all doses (150mcg, 300mcg and 500mcg) have been recalled and are not currently available. Please see our Latest News pages for updates on adrenaline auto-injector availability here.