Explaining adrenaline auto-injectors

Question 1

What are the different steps in explaining adrenaline auto-injectors?

Answer 1

• Why the patient has been prescribed this
• The features of the device
• When to use the device
• How to use the device
• Assessing patient understanding and technique
• Storage and care of EpiPens
• Closing the consultation

Question 2

How would you explain to patients why they have been prescribed an adrenaline auto-injector?

Answer 2

• You have been prescribed this EpiPen for your allergies as you recently had a severe allergic reactions
• It is used to given yourself adrenaline for the emergency treatment of severe allergic reactions/anaphylaxis

Question 3

How would you describe the features of an EpiPen to a patient?

Answer 3

1. Blue safety cap:
   - Stops the pen being activated accidentally
2. Viewing window
   - allows you to check the solution inside the device
3. Expiry date
   - replace the pen when just before the expiry date
4. Needle cover (orange plastic)
   - makes sure that they needle stays covered before and after use

Question 4

How would you describe to the patient when to use their EpiPen?

Answer 4

• Used to treat severe allergic reactions, known as anaphylaxis
• Symptoms can vary between individuals, but tend to develop suddenly and get worse after exposure to trigger
• Symptoms: light-headed/faint, breathing difficulties, wheezing, fast heartbeat, clammy skin, confusion + anxiety, collapsing/LOC
• Medical emergency and is life-threatening, important to treat early

Question 5

After explaining reason for EpiPen prescription, the features, and when to use the pen, what should you do?

Answer 5

Check patient understanding

Go back over anything they do not understand

Question 6

What should a patient do before using their EpiPen?

Answer 6

Using a training pen - explain to the patient that it does not contain a needle

1. Check the viewing window - if solution is not clear + colourless then do not use it
2. Check expiry date

Question 7

How should an EpiPen be used?

Answer 7

1. Remove from carry case and pull off blue safety cap
2. Hold the pen with your writing hand with orange needle pointing down to your thigh (blue to the sky, orange to the thigh)
3. Jab the pain firmly into outer thigh at a right angle (can be done over clothes)
4. Count to 3 (‘1 elephant, 2 elephant, 3 elephant’)
5. Remove the pen

Question 8

What should a patient do after using their EpiPen?

Answer 8

1. Call 999 - provide location
2. Lie down with legs raised slightly whilst waiting for the ambulance
3. If you have a 2nd EpiPen, use this if the ambulance has not arrived within 5-10 minutes
4. Take all EpiPens that you have used to the hospital with you

Question 9

What should you do after explaining to the patient how to use the EpiPen?

Answer 9

Assess their technique

Question 10

What information should you give to patients about the storage, care, and use of EpiPens?

Answer 10

• Keep the EpiPen in the outer casing to protect it from light
• Should have access to 2 EpiPens and you should carry them with you at all times
• Inform family/friends/work/school about your allergies and where to find your EpiPen if you have an allergic reaction
• Teach family and friends how to use the EpiPen (training pen will be provided)
• If you have to use your EpiPens for an allergic reactions, do not leave the hospital without replacements

Question 11

How should you close the EpiPen consultation?

Answer 11

• Ask patient if they have any questions
• Advise that they may wish to purchase a medic alert bracelet or similar object in case they are unable to communicate their allergies
• Provide info leaflet and training pen
• Any expired or unusable EpiPens can be taken to the pharmacy and be replaced

Question 12

List some resources about anaphylaxis that you can refer the patient to.

Answer 12

• Epipen.co.uk
• Anaphylaxis Campaign
• Allergy UK