A survey of Epi-PEN use in patients with a history of anaphylaxis,☆☆,,★★

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METHODS

Patients who had been prescribed Epi-PEN and were referred to our allergy clinic were the subjects of the study, which included questioning of patients and their parents (regardless of the patient’s age) on their knowledge of Epi-PEN. Patients and parents were also asked to demonstrate its use.

RESULTS

A total of 98 consecutive patients participated in this study. Ninety-three of them were less than 18 years of age, with ages ranging from 18 months to 18 years, and 15 were adults over the age of 18 years. We assumed that the primary trainees for patients under the age of 12 should be the parents, and for those over the age of 12, they should be the patients and the parents. Because of the smaller size of the adult population, we did not attempt to compare the 2 groups in relation to age.

DISCUSSION

Our survey illustrated alarmingly that many patients are not properly instructed in the use of Epi-PEN when the prescription is given. The 3 cases reported above further illustrate that a grave outcome may result when parents or patients erroneously feel that they are capable of managing an emergency or life-threatening event with Epi-PEN. I urge any physician who prescribes Epi-PEN to (1) give proper instructions to the patients or their parents (this should include the use of a demonstrator

References (3)

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    Because children tend to inject the device less forcefully, it is recommended that an adult give the injection.35 Results of a survey by Huang36 show that many patients are not properly instructed regarding the use of their prescribed auto-injectors. In another study, only 36% of parents were able to correctly fire the auto-injector device.37

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    Despite its vital and life-saving role, adrenaline is still underused or usually administered with a delay in the management of anaphylaxis.7 In previous studies, the rate of AAI usage was found to be quite low in children with recurrent episodes of anaphylaxis.8–10 Predictors of appropriate and inappropriate use of AAIs in clinical practice have not been well described.

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From the Division of Immunology & Infectious Diseases, Department of Pediatrics, University of Florida College of Medicine, Gainesville.

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Reprint requests: Shih-Wen Huang, MD, Division of Immunology & Infectious Diseases, Department of Pediatrics, Box 100296, University of Florida College of Medicine, Gainesville, FL 32610.

J Allergy Clin Immunol 1998;102:525-6.

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