Adrenaline for anaphylaxis kits – a reminder to health care professionals

Adrenaline for anaphylaxis kits – a reminder to health care professionals

October 10, 2018

Following the recent Department of Health and Social Care Supply Disruption Alert on EpiPen® and EpiPen Junior® adrenaline auto-injectors (AAIs) that advises conserving supplies for patients who truly need them, NHS Improvement has issued a reminder letter to community pharmacies and GP practices that healthcare professionals can use adrenaline ampoules to treat anaphylactic reactions.

The letter states that some healthcare professionals may be holding EpiPens® or other AAIs, in preference to adrenaline ampoules to treat anaphylaxis; however, this should not be necessary. All healthcare professionals providing services where anaphylaxis treatment may be required, including but not exclusive to the Flu Vaccination Service, should have the competency to draw up and administer adrenaline from ampoules with a normal syringe and needle.

NHS Improvement has therefore advised that when adrenaline needs to be replaced in anaphylaxis kits, that adrenaline ampoules are used (dosing charts, needles and syringes should also be included) rather than AAIs.  This will reduce the reliance on AAIs and therefore preserve essential EpiPen® stocks for patients, parents, carers, teachers, etc. who, as lay persons, cannot be expected to administer adrenaline via a needle and syringe.

Read the NHS Improvement Letter: Adrenaline for anaphylaxis kits – a reminder to health care professionals

Frequently asked questions:

Q. What would normally be contained in an anaphylaxis pack?
The Green Book states that an anaphylaxis pack normally contains two ampoules of adrenaline (epinephrine) 1:1000, four 23G needles and four graduated 1ml syringes, and Laerdal or equivalent masks suitable for children and adults. The mask for children would only be required if the pharmacy is providing a vaccination service to children; the Advanced Service does not include the vaccination of children.

Q. If a pharmacist administers adrenaline in an emergency to treat anaphylaxis, is a PGD required to authorise the administration?
No. Regulation 238 of the Human Medicines Regulations 2012 allows adrenaline to be administered by anyone for the purpose of saving life in an emergency.

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