Abstract
The epinephrine autoinjector (EpiPen, DEY, L.P., Napa, CA) is a lifesaving device, but the teaching of its use has not been properly evaluated. We enrolled parents of pediatric patients (n = 224) with a history of anaphylaxis in a study to evaluate teaching of the use of the EpiPen. Parents were taught nine steps to the correct use of the EpiPen, and were then tested on their knowledge and skills in subsequent visits using a demonstrator. The pass rate was determined for each step on each visit. We found that only 22% (49 of 224) of parents passed all nine tests in the first visit; 68% (152 of 224) passed the tests on the second visit; 94% (211 of 224) passed all of the tests after the third visit; and 6.5% (15 of 224) of parents failed to pass the test even after five visits. The highest failure rates were for the instructions to “press the device until it clicks” and to “press the device steadily for 10 seconds.” Parents who had previously been given an EpiPen demonstrator had a significantly better pass rate than those who had not, and those whose children who presented with insect sting allergy had a better pass rate than those whose children had food allergy. We concluded that: (1) many parents of children with a history of anaphylaxis lack the skill to administer EpiPen effectively; (2) staff in allergy clinics should take an active role in teaching and continuing to explain the use of EpiPen; and (3) prescriptions for EpiPen should include a demonstrator. (Pediatr Asthma Allergy Immunol 2007; 20[1]:19–22.)
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