Living with severe allergies can be challenging, but thankfully, advancements in medical technology have provided us with tools to manage and mitigate the risks. Adrenaline auto-injectors have emerged as crucial devices in emergency situations, where immediate treatment is required to counter allergic reactions, such as anaphylaxis.
In this blog post, we will delve into the world of adrenaline auto-injectors, discussing heat exposure concerns, various brands and recent recalls, the importance of carrying two devices, legislation and regulations, treatment procedures, and the potential role of other medications like antihistamines in treating allergic reactions.
How Adrenaline Works
Adrenaline treats anaphylaxis by doing three important things:
It helps to open up the airways: During anaphylaxis, the airways can become narrow, making it difficult to breathe. Adrenaline relaxes the muscles in the airways, making them wider and allowing air to flow more easily.
It reduces swelling and itching: Anaphylaxis can cause swelling, itching, and hives. Adrenaline helps to decrease this swelling and itching by blocking the release of chemicals that cause these symptoms.
It improves blood pressure: Anaphylaxis can cause a drop in blood pressure, which can be dangerous. Adrenaline helps to raise blood pressure by constricting the blood vessels, ensuring that the vital organs receive enough blood and oxygen.
Heat Exposure and Storage of Adrenaline
If you live anywhere in the UK then you’ll know it’s been HOT recently. Heat exposure is a critical factor to consider when it comes to adrenaline auto-injectors. These devices contain a liquid formulation of adrenaline, which can degrade when exposed to high temperatures. Exposure to high temperatures can potentially degrade the medication or affect the injector's functionality. Always check the storage instructions provided by the manufacturer to ensure the optimal conditions for your specific brand.
Adrenaline pens normally have a window where you can check if the adrenaline is clear or cloudy.
It is essential to store auto-injectors in a cool, dry place, away from direct sunlight and extreme temperatures, otherwise, the adrenaline inside the pens can spoil - you can tell this has happened if the liquid goes ‘cloudy’.
Avoid leaving them in hot cars or exposed to prolonged sunlight, as this can compromise their effectiveness. We always advise that our Anaphylaxis Kitts are installed in areas where there’s no direct heat source, such as a radiator or beaming sunlight.
Always refer to the manufacturer's instructions for proper storage guidelines.
The Different Brands: Jext, Epipen & Emerade:
There are several brands of adrenaline auto-injectors available on the market, including Epipen, Jext, and Emerade. Each pen inevitably does the same job, but the brands may have slight variations in design, administration technique, and expiration dates. It is essential to familiarize yourself with the specific instructions for the brand you are prescribed.
In recent years, there have been concerns regarding the reliability of Emerade auto-injectors. In certain batches, malfunctions were reported, leading to the recall of the affected devices. This underscores the importance of staying updated with product recalls and checking the expiration dates of your adrenaline auto-injectors regularly. In the event of a recall or expired device, promptly contact your healthcare provider to obtain a replacement.
For more information on the different brands and doses, see our interview with Professor Adam Fox.
Always Carry Two Auto-Injectors:
It is strongly recommended to carry two adrenaline auto-injectors with you at all times if you have a history of severe allergies or anaphylaxis. Allergic reactions can vary in intensity, and in some cases, a single dose may not be sufficient to manage the symptoms effectively.
In fact, as of this weekend (17th June 2023) the British Society for Allergy and Clinical Immunology (BSACI) updated their official guidance on this, stating:
’The guidance recommends GPs to provide two adrenaline auto injectors for those at significant risk of anaphylaxis and to always carry them. Where the healthcare professional is uncertain about the risk of anaphylaxis, prescribing adrenaline would be a safety net, pending review in a specialist allergy clinic. Patients who are prescribed an AAI or considered at risk of anaphylaxis must then be referred on to be reviewed by an allergy specialist.’
Carrying two auto-injectors also ensures that a backup is readily available in case of malfunction, delayed response, or the need for a second dose. Having a spare auto-injector can provide a crucial second chance to administer the necessary medication before seeking medical assistance.
Legislation and Regulations:
Different countries may have specific legislation and regulations concerning adrenaline auto-injectors. These regulations can address topics such as the availability of AAIs in public spaces, training requirements for their use, and guidelines for their prescription and supply. It is essential to be aware of the regulations applicable to your region and follow them accordingly.
In the UK for example, there are specific amendments (The Human Medicines Regulations 2017) to allow schools to purchase and stock unprescribed or ‘spare’ adrenaline pens, which can be used for emergency purposes on those who were never prescribed their own, or on those who have their own pens but they’ve been forgotten or are out of date.
As of 2017, schools can now stock spare adrenaline pens for use in emergency scenarios.
Treatment Procedures and Other Medications:
Adrenaline auto-injectors are typically the first line of defence in treating anaphylaxis. When an allergic reaction occurs, promptly administer the auto-injector into the outer thigh, even through clothing if necessary. After administration, seek immediate medical attention, as anaphylaxis requires comprehensive medical evaluation and treatment.
In addition to adrenaline, other medications, such as antihistamines, may be prescribed to help manage allergic symptoms. Antihistamines work by blocking the effects of histamine, a chemical released during an allergic reaction. However, it is important to note that antihistamines alone cannot reverse the life-threatening symptoms of anaphylaxis and should not be relied upon as a standalone treatment.
The Anaphylaxis Kitt
Kitt Medical was founded by Zak Marks, who lives with a severe nut allergy and has always had to carry two adrenaline pens with him wherever he goes. He identified personally with the issues millions face around the UK, and decided to create something ‘just like a defibrillator, but for allergies’.
In our Anaphylaxis Kitts we provide a spare set of adrenaline pens: 2x 150mcg and 2x300mcg, provided on a subscription basis, to schools in the UK.
The Anaphylaxis Kitt containing emergency adrenaline pens for treating anaphylaxis.
This comes alongside our CPD-accredited anaphylaxis training course to help amplify awareness and preparedness around the school.
To learn more, click here.
Conclusion:
Adrenaline auto-injectors are indispensable devices for individuals with severe allergies, providing a swift and effective response to life-threatening allergic reactions. Proper storage, staying informed about recalls, carrying two auto-injectors, and complying with legislation and regulations are essential for ensuring the devices' efficacy. Remember, timely administration of adrenaline, in conjunction with appropriate medical care, can significantly increase the chances of a positive outcome in an allergic emergency. Stay informed, prepared, and advocate for your health and safety.
