With the current stock shortages of EpiPen Jr® (Junior) in South Africa, we are once again reminded of the importance of access to adrenaline in case of a severe reaction.
Early injection of adrenaline in anaphylaxis has been shown to significantly reduce the progression of the reaction. Its role is to treat current symptoms and to prevent more severe symptoms from occurring. Delayed injection of adrenaline has been closely linked to deaths from anaphylaxis.
Adrenaline autoinjectors are designed to allow quick administration of a fixed dose of adrenaline into the thigh muscle. In many parts of the world these life-saving devices are not available and where they are available, they are under-prescribed and under-used. One study revealed that only 11% of people who had an anaphylactic reaction had been prescribed an adrenaline auto-injector that they went on to use at the time of the reaction.
In South Africa, EpiPen® is the only adrenaline autoinjector available. EpiPens are available in two different doses– EpiPen 0.3mg, which is suitable for individuals >25kg, and EpiPen Jr® 0.15mg, which is suitable for children weighing 7.5kg- 25kg.
Should you require an EpiPen® your doctor needs to provide you with a prescription for the correct dose, provide you with an anaphylaxis action plan and give you clear instructions about how to use the EpiPen®. The alternative is to draw up a dose of adrenaline from an ampoule and administer the dose using a needle and syringe. However, this requires adequate training, is more time consuming and may lead to dosing errors.
Remember there is no circumstance in which you absolutely can not administer adrenaline for a suspected severe reaction! And the sooner the better