Tips re Adrenaline Autoinjector use
You can never have enough training for administering an adrenaline autoinjector (AAI).
As simple as the devices appear, administration can prove tricky in the acute setting.
Allergic reactions will vary in severity, this is true between patients and within patients i.e. not all reactions will be the same.
Many variables determine the severity of a reaction; these include age, asthma diagnosis, amount and form of the food allergen eaten…
Most allergic reactions will commence with ‘mild-moderate’ symptoms and signs and will progress no further. If symptoms are mild the patient can be observed, whilst communicating for medical help, and all symptoms will hopefully settle with time and antihistamine administration.
Severe symptoms warrant the administration of an AAI. The challenge is to know what to do when symptoms are in a ‘moderate range’.
I teach families, that for the most part, mild symptoms will be observed on the ‘outside of the body’ (e.g. redness, hives, lip swelling, vomiting). More worrying symptoms occur on the ‘inside of the body’ (e.g. altered voice, difficulty breathing, wheezing, new onset repetitive cough, suddenly sleepy/faint/dizzy/absent, tongue swelling). If a BP and/or Sat can be measured and is low then this is obv a severe sign.
If in doubt, err on the side of AAI administration; it is a natural hormone of the body and will not harm (other than psychological stress for all).
Points I would like to emphasise that you may not have been taught include:
Please hold the patient's thigh firmly to prevent them from kicking; this can cause a laceration as the needle is long and strong’ and will tear the tissue if the thigh moves with force.
If a second device is required, please be sure to administer this in the alternate thigh to that in which the first device was administered. Adrenaline vasoconstricts and the first dose will reduce the absorption of the second dose if administered at the same site.
If you are uncertain if a dose has been administered, the patient’s pupils should dilate a few minutes after administration; this is normal as part of the ‘fight-or-flight’ response.
