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Allergy patients often ‘too scared’ to use injector

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Nurses should educate patients who are supposed to carry adrenaline auto-injectors due to their allergy risk “at every opportunity”, according to new guidance.

The British Society for Allergy and Clinical Immunology has published guidance on the adrenaline auto-injectors that patients carry with them so they can self-treat when severe symptoms begin.

“These devices are only one part of the management of anaphylaxis”

Shuaib Nasser

The new guidance covers when adrenaline auto-injectors should be prescribed, who needs one, how many pens should each patient carry and ensuring patients are able to use them.

An adrenaline auto-injector – AAI or “adrenaline pen” – should be prescribed for those at risk of anaphylaxis, stated the guidance.

The injector should be prescribed soon after the acute episode, either in accident and emergency or by in a GP practice, “promptly after recovery”.

Patients must be trained how to use these devices and when to use them, when they are prescribed, added the guidance.

But it warned that patients commonly failed to carry the device and did not know how to use it or were afraid to.

Therefore, the society said it recommended that “retraining and education at every opportunity are essential”.

In the case of children, the education of parents, carers and school staff is also required, to make children safe, warned the guidance.

However, it noted that prescribing an adrenaline auto-injector was “only one step” in managing anaphylaxis risk and was “not by itself enough”.

The injector should be combined with diagnosis of why anaphylaxis occurred, allergy advice on avoidance of triggers, a written treatment plan, as well as training in the use of the auto-injector.

Normally only one device is required for self-administration, said the guidance, though two were needed for children – one usually kept at school and one for use at all other times.

British Society for Allergy and Clinical Immunology

Allergy patients often ‘too scared’ to use injector

Shuaib Nasser

It added: “There are exceptions where two may be required in one kit. Decisions should always be made by the individual clinician based on their clinical judgement.”

Society president Dr Shuaib Nasser said the new document provided “comprehensive guidance on who should be prescribed an adrenaline auto-injector for the treatment of life-threatening allergic reactions”.

He added: “These devices are only one part of the management of anaphylaxis and must be combined with identification of triggers, avoidance advice and a written emergency treatment plan combined with regular training in their use.”

The guideline will be published in the journal Clinical & Experimental Allergy on 29 September.

The British Society for Allergy and Clinical Immunology is the national, professional and academic society that represents the specialty of allergy at all levels.

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