Setting up a Care Plan
There is strong evidence to show that the risks from allergy will be reduced if you follow a written Care Plan. A Care Plan will help you recognise when an allergic reaction has started and show you how to treat it. Your allergy clinic or GP may help you set this up, or the Anaphylaxis Campaign Helpline can offer guidance – phone 01252 542029 or email us. The BSACI has also created a guide to making a care plan to facilitate first aid treatment of anaphylaxis, to be delivered by people without any special medical training nor equipment apart from access to an adrenaline auto-injector (AAI). For more information please read about allergy action plans.
Carrying your medication
If you have been prescribed treatments for your allergy — such as injectable adrenaline — the golden rule is, carry it everywhere at all times, with no exceptions. It’s important to make sure others are aware of what to do when a reaction occurs, such as relatives and close friends.
Asthma control
If you have asthma as well as allergies, your asthma should be well controlled. Poorly-controlled asthma will raise the chances of any allergic reaction being severe. If your asthma needs more treatment than usual, you should take extreme care to avoid those foods or substances that might cause a reaction. You will also need to discuss your asthma with your GP.
About adrenaline injectors
There are three adrenaline injectors available on prescription in the U.K.
Emerade
Emerade is the most recent single-use adrenaline auto-injector to become available. Emerade follows the UK Resuscitation Council’s Guidelines for the Emergency treatment of anaphylactic reactions.
Visit their website for more information and to watch a video demonstration.
To receive Emerade product information or patient education materials, contact them here or 020 8781 2920
Distributor: Baush + Lomb UK Ltd, 106 London Road, Kingston upon Thames KT2 6TN
EpiPen
The EpiPen has a spring-loaded concealed needle that delivers a single measured dose when the pen is jabbed against the muscle of the outer thigh.
Visit their website for more information, to watch a video demonstration and to register for expiry alerts.
Distributor: Mylan, Building 4 Trident Place Mosquito Way, Hatfield AL10 9UL
Jext
Jext has a locking needle shield which engages after use, designed to protect against needle stick injury.
Visit their website for more information, to watch a video demonstration and to register for expiry alerts.
Distributor: ALK-Abelló Ltd, 1 Manor Park, Manor Farm Road, Reading, Berkshire, RG2 0NA. 0118 903 7940
Advice on using adrenaline auto-injectors
How many injectors should I carry?
The UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) advised in June 2014 that anyone
who is at risk of suffering anaphylaxis should always have two adrenaline injector devices immediately
available for use (MHRA, 2014). The MHRA report said: “It is acknowledged that in some cases, a single
injection is not sufficient to achieve a response for a number of reasons, including severity of attack as well as the possibility that a dose has not been effectively administered; a second injection may therefore be needed.” The Anaphylaxis Campaign supports this view.
In cases where the risk of anaphylaxis is thought to be low, there is a difference of opinion among members of the medical community. While some doctors agree that two injectors must always be immediately available (in line with the MHRA report), others believe it is sufficient to have one device available, arguing that one injection is likely to be enough to treat the symptoms until emergency medical help arrives.
This is a matter that you should discuss thoroughly with your allergist
Key messages
If you or your child carries adrenaline, there are key messages you must remember:
- Have your adrenaline with you at all times, no exceptions.
- Check the expiry date regularly. An out-of-date injector may offer some protection, but this will be limited.
- Get a health professional to show you how to use your injector. If you haven’t already been shown how, go back to the doctor who prescribed it and ask for a demonstration. Ask the practice nurse at your local GP surgery or the school nurse. AllergyWise online can help.
- Get hold of a “trainer” pen and practise regularly: click here to order an Emerade trainer device, click here to order an EpiPen trainer device orclick here to order a Jext trainer device
- If you suspect a reaction is serious or becoming serious, use your injector immediately, any delay could be extremely serious. Dial 999 or get someone else to do it. Immediately after your adrenaline has been administered you will need to get to hospital because the symptoms can return and you may need further treatment.
- Remember that children who have been prescribed Jext or Emerade adrenaline injectors need to go on to the higher dose when they weigh 30kg or 4 stone 9 lbs. This is likely to be somewhere between 5-11 years old. Infants and children who have been prescribed EpiPen will be prescribed the Junior version if they weigh between 7.5kg and 25kg. The higher dose EpiPen is suitable for adults and children weighing over 25kg.
For more information and advice please call our helpline on 01252 542029 or email our helpline team.