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Volume 2025, Issue 2
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Allergic disorders are steadily increasing, and so is the incidence of anaphylaxis. Epinephrine is the drug of choice for anaphylaxis. Fatalities from anaphylaxis occur if epinephrine is not administered or delayed in administration. Epinephrine is not effective orally but works rapidly if administered intramuscularly. Epinephrine can be delivered easily via Epinephrine AutoInjector (EAI), safely and soon after the onset of anaphylaxis, and can be carried portably. There are few approved EAI brands, but EpiPen is the most commonly used brand. Accidental EAI injuries are increasing in prevalence in the community and also among the healthcare workers while administering it. Injuries occur to any part but mostly to the limb digits. According to evidence, most injuries make full recovery. We present two cases of healthcare professionals who experienced accidental EAI injury at the primary care health center. The designs of alternate EAIs compared with EpiPen are safer for both the public and the healthcare professionals while delivering the same result. Regular training in the use of EAI reduces the accidental injuries.

© 2025 Sheik, Zafar, licensee HBKU Press.
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2025-04-29
2025-05-20
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References

  1. Pawankar R, Holgate ST, Canonica GW, Lockey RF, Blaiss MS. WAO white book on allergy: Update 2013 [Internet]. MilwaukeeWorld Allergy Organisation; 2013. Available from: https://allergypaais.org/wp-content/themes/twentytwentyone/pdf/ExecSummary-2013-v6-hires.pdf
     [Google Scholar]
  2. Sicherer SH, Simons FER. Section on allergy and immunology AA of P. Self-injectable epinephrine for first-aid management of anaphylaxis. Pediatrics. 2007Mar; 119:(3):638–46. https://doi.org/10.1542/peds.2006-3689
     [Google Scholar]
  3. Rudders SA, Arias SA, Camargo CA. Trends in hospitalizations for food-induced anaphylaxis in US children, 2000–2009. J Allergy Clin Immunol. 2014Oct; 134:(4):960–2.e3. https://doi.org/10.1016/j.jaci.2014.06.018
     [Google Scholar]
  4. The European Academy of Allergy and Clinical Immunology. Tackling the allergy crisis in Europe – Concerted policy action needed [Internet]. Belgium Tackling the allergy crisis in Europe – Concerted policy action needed [Internet]2015. Available from: https://eaaci.org/wp-content/uploads/2024/02/EAACI_Advocacy_Manifesto.pdf
     [Google Scholar]
  5. Ibrahim NM, Almarzouqi FI, Al Melaih FA, Farouk H, Alsayed M, AlJassim FM. Prevalence of asthma and allergies among children in the United Arab Emirates: A cross-sectional study. World Allergy Organ J. 2021Oct6; 14:(10):100588. https://doi.org/10.1016/j.waojou.2021.100588
     [Google Scholar]
  6. Nwaru BI, Hickstein L, Panesar SS, Roberts G, Muraro A, Sheikh A, et al. Prevalence of common food allergies in Europe: A systematic review and meta-analysis. Allergy. 2014Aug; 69:(8):992–1007. https://doi.org/10.1111/all.12423
     [Google Scholar]
  7. Turner PJ, Campbell DE, Motosue MS, Campbell RL. Global trends in Anaphylaxis epidemiology and clinical implications. J Allergy Clin Immunol Pract. 2020Apr; 8:(4):1169–76. https://doi.org/10.1016/j.jaip.2019.11.027
     [Google Scholar]
  8. Pumphrey RS. Lessons for management of anaphylaxis from a study of fatal reactions. Clin Exp Allergy. 2000Aug; 30:(8):1144–50. https://doi.org/10.1046/j.1365-2222.2000.00864.x
     [Google Scholar]
  9. Simons FER, Edwards ES, Read EJ, Clark S, Liebelt EL. Voluntarily reported unintentional injections from epinephrine auto-injectors. J Allergy Clin Immunol. 2010Feb; 125:(2):419–23.e4. https://doi.org/10.1016/j.jaci.2009.10.056
     [Google Scholar]
  10. Mrvos R, Anderson BD, Krenzelok EP. Accidental injection of epinephrine from an autoinjector: Invasive treatment not always required. South Med J. 2002Mar; 95:(3):318–20. Available from: https://pubmed.ncbi.nlm.nih.gov/11902698/
     [Google Scholar]
  11. Wright M. Treatment after accidental injection with epinephrine autoinjector: A systematic review. J Allergy Ther [Internet]. 2014; 05:(03). Available from: https://www.omicsonline.org/open-access/treatment-after-accidental-injection-with-epinephrine-autoinjector-2155-6121.1000175.php?aid=26513
     [Google Scholar]
  12. Dalal R, Grujic D. Epinephrine [Internet]. StatPearls2024. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30644586
     [Google Scholar]
  13. Simons FE, Gu X, Simons KJ. Epinephrine absorption in adults: intramuscular versus subcutaneous injection. J Allergy Clin Immunol. 2001Nov; 108:(5):871–3. https://doi.org/10.1067/mai.2001.119409
     [Google Scholar]
  14. Roy A, Geetha RV, Magesh A, Vijayaraghavan R, Ravichandran V. Autoinjector – A smart device for emergency cum personal therapy. Saudi Pharm J. 2021Oct; 29:(10):1205–15. https://doi.org/10.1016/j.jsps.2021.09.004
     [Google Scholar]
  15. Campbell RL, Bellolio MF, Motosue MS, Sunga KL, Lohse CM, Rudis MI. Autoinjectors Preferred for intramuscular epinephrine in Anaphylaxis and allergic reactions. West J Emerg Med. 2016Nov; 17:(6):775–82. https://doi.org/10.5811/westjem.2016.8.30505
     [Google Scholar]
  16. McGovern SJ. Treatment of accidental digital injection of adrenaline from an auto-injector device. J Accid Emerg Med. 1997Nov; 14:(6):379–80. https://doi.org/10.1136/emj.14.6.379
     [Google Scholar]
  17. Peyko V, Cohen V, Jellinek-Cohen SP, Pearl-Davis M. Evaluation and treatment of accidental autoinjection of epinephrine. Am J Health Syst Pharm. 2013May1; 70:(9):778–81. https://doi.org/10.2146/ajhp120316
     [Google Scholar]
  18. Posner LS, Camargo CA. Update on the usage and safety of epinephrine auto-injectors, 2017. Drug Healthc Patient Saf. 2017Mar21; 9:9–18. https://doi.org/10.2147/DHPS.S121733
     [Google Scholar]
  19. Bodkin RP, Acquisto NM, Gunyan H, Wiegand TJ. Two cases of accidental injection of epinephrine into a digit treated with subcutaneous phentolamine injections. Case Rep Emerg Med. 2013: 2013:586207. https://doi.org/10.1155/2013/586207
     [Google Scholar]
  20. McNeil C, Copeland J. Accidental digital epinephrine injection: to treat or not to treat? Can Fam Physician. 2014Aug; 60:(8):726–8. Available from: https://pubmed.ncbi.nlm.nih.gov/25122817/
     [Google Scholar]
  21. Muck AE, Bebarta VS, Borys DJ, Morgan DL. Six years of epinephrine digital injections: Absence of significant local or systemic effects. Ann Emerg Med. 2010Sep; 56:(3):270–4. https://doi.org/10.1016/j.annemergmed.2010.02.019
     [Google Scholar]
  22. Guerlain S, Hugine A, Wang L. A comparison of 4 epinephrine autoinjector delivery systems: usability and patient preference. Ann Allergy Asthma Immunol. 2010Feb; 104:(2):172–7. https://doi.org/10.1016/j.anai.2009.11.023
     [Google Scholar]
  23. Anshien M, Rose SR, Wills BK. Unintentional epinephrine auto-injector injuries: A national poison center observational study. Ann Allergy Asthma Immunol. 2010Feb; 104:(2):172–7. https://doi.org/10.1016/j.anai.2009.11.023
     [Google Scholar]
  24. Kessler C, Edwards E, Dissinger E, Sye S, Visich T, Grant E. Usability and preference of epinephrine auto-injectors: Auvi-Q and EpiPen Jr. Ann Allergy Asthma Immunol. 2019Sep; 123:(3):256–62. https://doi.org/10.1016/j.anai.2019.06.005
     [Google Scholar]
/content/journals/10.5339/jemtac.2025.20
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Needle stick injury from epinephrine autoinjector to healthcare professionals: Two case reports
Journal of Emergency Medicine, Trauma and Acute Care 2025, 20 (2025); https://doi.org/10.5339/jemtac.2025.20
/content/journals/10.5339/jemtac.2025.20
/content/journals/10.5339/jemtac.2025.20
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  • Article Type: Case Report
Keyword(s): anaphylaxis, autoinjectors, epinephrine, healthcare professional safety and patient safety

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