Autoinjectors Preferred for Intramuscular Epinephrine in Anaphylaxis and Allergic Reactions.
BACKGROUND
Epinephrine is the treatment of choice for anaphylaxis. We surveyed emergency department (ED) healthcare providers regarding two methods of intramuscular (IM) epinephrine administration (autoinjector and manual injection) for the management of anaphylaxis and allergic reactions and identified provider perceptions and preferred method of medication delivery.


METHODS
This observational study adhered to survey reporting guidelines. It was performed through a Web-based survey completed by healthcare providers at an academic ED. The primary outcomes were assessment of provider perceptions and identification of the preferred IM epinephrine administration method by ED healthcare providers.


RESULTS
Of 217 ED healthcare providers invited to participate, 172 (79%) completed the survey. Overall, 82% of respondents preferred the autoinjector method of epinephrine administration. Providers rated the autoinjector method more favorably for time required for training, ease of use, convenience, satisfaction with weight-based dosing, risk of dosing errors, and speed of administration (p<0.001 for all comparisons). However, manual injection use was rated more favorably for risk of provider self-injury and patient cost (p<0.001 for both comparisons). Three participants (2%) reported a finger stick injury from an epinephrine autoinjector.


CONCLUSIONS
ED healthcare providers preferred the autoinjector method of IM epinephrine administration for the management of anaphylaxis or allergic reactions. Epinephrine autoinjector use may reduce barriers to epinephrine administration for the management of anaphylaxis in the ED.
Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota.
Ronna L
RL
Campbell
Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota.
M Fernanda
MF
Bellolio
Mayo Clinic, Division of Allergic Diseases, Rochester, Minnesota.
Megan S
MS
Motosue
Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota.
Kharmene L
KL
Sunga
Mayo Clinic, Division of Biomedical Statistics and Informatics, Rochester, Minnesota.
Christine M
CM
Lohse
Mayo Clinic, Pharmacy Services, Rochester, Minnesota.
Maria I
MI
Rudis
D000707:Anaphylaxis / Q000188:drug therapy*; D004636:Emergency Service, Hospital; D004837:Epinephrine / Q000008:administration & dosage*; D004867:Equipment Design; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods*; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires
D004837:Epinephrine