Voluntarily reported unintentional injections from epinephrine auto-injectors - 13/08/11
, Eric S. Edwards, BS b, Edward J. Read, MD c, d, Sunday Clark, MPH, ScD e, Erica L. Liebelt, MD f
Reprint requests: F. Estelle R. Simons, MD, Room FE125, 820 Sherbrook Street, Winnipeg, Manitoba, Canada R3A 1R9.Abstract |
Background |
Epinephrine auto-injectors provide life-saving prehospital treatment for individuals experiencing anaphylaxis in community settings.
Objective |
To determine the number, demographics, and associated circumstances and outcomes of unintentional injections from epinephrine auto-injectors.
Methods |
We searched the databases of the American Association of Poison Control Centers and the Food and Drug Administration’s Safety Information and Adverse Event Report System for these incidents as reported by members of the public and by health care professionals.
Results |
From 1994 to 2007, a total of 15,190 unintentional injections from epinephrine auto-injectors were reported to US Poison Control Centers, 60% of them from 2003 to 2007. Those unintentionally injected had a median age of 14 years (interquartile range, 8-35), 55% were female, and 85% were injected in a home or other residence. Management was documented in only 4101 cases (27%), of whom 53% were observed without intervention, 29% were treated, 13% were neither held for observation nor treated, and 4% refused treatment. In contrast, from 1969 to 2007, only 105 unintentional injections from epinephrine auto-injectors were reported to MedWatch. Forty percent of these occurred during attempts to treat allergic reactions. Injuries resulting in permanent sequelae were rarely reported to either US Poison Control Centers or to MedWatch.
Conclusion |
The number of reported unintentional injections from epinephrine auto-injectors increased annually from 1994 to 2007. To prevent these unintentional injections, improved epinephrine auto-injector design is needed, along with increased vigilance in training the trainers and in training and coaching the users, as well as efforts to increase public awareness of the role of epinephrine auto-injectors in the first-aid treatment of anaphylaxis in the community.
Le texte complet de cet article est disponible en PDF.Key words : Epinephrine auto-injector, adrenaline auto-injector, anaphylaxis, acute allergic reaction, unintentional injection, needle stick injury, sharps injury
Abbreviations used : AAPCC, AERS, FDA, IQR, PCC
Plan
| Disclosure of potential conflict of interest: F. E. R. Simons has received research support from the Canadian Institutes of Health Research and serves on advisory boards for Dey, Intelliject, ALK-Abelló, Lincoln Medical, and Sciele. E. S. Edwards owns stock in Intelliject. E. J. Read, Jr, is an investor and a scientific advisor for Intelliject. S. Clark has received consulting fees from Dey and Partners Healthcare/Massachusetts General Hospital. E. L. Liebelt is an examination test question writer for the American Board of Pediatrics; has served as an expert witness on the topics of salicylate poisoning, phenytoin toxicity, and opiate toxicity; and is President of the American College of Medical Toxicology. |
Vol 125 - N° 2
P. 419 - février 2010 Retour au numéro
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