Auto-injector needle length may be inadequate to deliver epinephrine intramuscularly in women with confirmed food allergy

Allergy, Asthma and Clinical Immunology

Volumn 10, Issue 1, 2014, Pages

  Tsai, Gina ^a   Kim, Laura ^b   Nevis, Immaculate F P ^a,c   Dominic, Arunmozhi ^a   Potts, Ryan ^d   Chiu, Jack ^a   Kim, Harold L ^a,c,e  

^a WESTERN UNIVERSITY   (Canada)

^b MCGILL UNIVERSITY   (Canada)

^c MCMASTER UNIVERSITY   (Canada)

^d UNIVERSITY OF WATERLOO   (Canada)

^e NONE   (Canada)

Author keywords

Anaphylaxis; Auto injector; Epinephrine; Food allergy; Needle length; Skin to muscle depth

Indexed keywords

EID: 84904518433     PISSN: 17101484     EISSN: 17101492     Source Type: Journal    
DOI: 10.1186/1710-1492-10-39     Document Type: Article

References (15)

1. Kim HL. Fischer D. Anaphylaxis: Allergy Asthma Clin Immunol 2011, 7(Suppl 1):S6.
2. Pumphrey RS. Lessons for management of anaphylaxis from a study of fatal reactions. Clin Exp Allergy 2000, 30:1144-1150.
3. Simons FE, Ardusso RF, Dimov V, Ebisawa M, El-Gamal YM, Lockey RF, Sanchez-Borges M, Senna GE, Sheikh A, Thong BY, Worm M. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol 2013, 162:193-204.
4. Simons FER, Roberts JR, Gu X, Simons KJ. Epinephrine absorption in children with a history of anaphylaxis. J Allergy Clin Immunol 1998, 101:33-37.
5. Simons FER, Gu X, Simons KJ. Epinephrine absorption in adults: intramuscular versus subcutaneous injection. J Allergy Clin Immunol 2001, 108:871-873.
6. EpiPen®/EpiPen® Jr Prescribing Information 2012, Napa, California: Dey Pharma, Available at: https://www.epipen.ca/sites/default/files/pdf/hcp/en/English_PI.pdf. Accessed May 23, 2014.
7. Wilmot JG, Shukla RB, Mesa CL, Mahadevan MV. Inventors 2012, Meridian Medical Technologies, Inc, assignee; High-efficiency auto-injector, US patent US2012/0101475A1.
8. Bhalla MC, Gable BD, Frey JA, Reichenbach MR, Wilber ST. Predictors of epinephrine autoinjector needle length inadequacy. Am J Emerg Med 2013, 31:1671-1676.
9. Song TT, Nelson MR, Chang JH, Engler RJ, Chowdhury BA. Adequacy of the epinephrine autoinjector needle length in delivering epinephrine to the intramuscular tissues. Ann Allergy Asthma Immunol 2005, 94:539-542.
10. Song TT, Merrill NL, Cole JW. Delivery depth of epinephrine by auto-injector into the subcutaneous tissue of pig. Ann Allergy Asthma Immunol 2013, 111:143-145.
11. Simons FER, Chan ES, Gu X, Simons KJ. Epinephrine for the out-of-hospital (first-aid) treatment of anaphylaxis in infants: is the ampule/syringe/needle method practical?. J Allergy Clin Immunol 2001, 108:1040-1044.
12. Emerade®: The New Adrenaline Auto-injector for Emergency Treatment of Anaphylaxis London, UK: iMed Systems Ltd, Available: http://www.emerade.com/hcp/adrenaline-auto-injector (accessed 2014 May 26).
13. Woodbridge: grieving family in 'learn lessons' plea after teen's peanut cake death 2011, EADT24, Available: http://www.eadt.co.uk/news/woodbridge_grieving_family_in_learn_lessons_plea_after_teen_s_peanut_cake_death_1_948194 (accessed 2014 May 26).
14. European Medicines Agency Adrenaline Auto-injectors 2014, Available: http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/referrals/Adrenaline_auto_injectors/human_referral_000367.jsp&mid=WC0b01ac05805c516f (accessed 2014 May 26), European Medicines Agency.
15. Centre for Disease Control and Prevention Overweight and Obesity 2012, Available: http://www.cdc.gov/obesity/data/adult.html (accessed 2014 May 26), Centre for Disease Control and Prevention.