Children's Hospital for Wales, University Hospital for Wales, Cardiff, UK.
Pediatr Allergy Immunol. 2013 Mar;24(2):173-7. doi: 10.1111/pai.12048. Epub 2013 Mar 1.
Intramuscular epinephrine (adrenaline) is the first-line therapy for anaphylaxis and prompt administration improves outcome. In 2011, two epinephrine autoinjectors existed in the United Kingdom, differing in their users' administration method: EpiPen(®) and Anapen(®) . We routinely train all families who receive these devices.
To evaluate: Maternal competence in using epinephrine autoinjectors following our standard anaphylaxis training package. Which device mothers found easier to use.
Mothers with no previous epinephrine autoinjector experience were approached to participate. One clinician provided a standardized demonstration on using a randomly assigned autoinjector device. She immediately evaluated the mothers' performance using ten predetermined criteria. Four criteria were device specific and six were common criteria to both devices.
One hundred mothers participated: 50 EpiPen(®) and 50 Anapen(®) . A substantial proportion of mothers (15% overall) were not able to successfully 'fire' these training devices: Anapen(®) 4% and EpiPen(®) 26% (OR 8.43, p = 0.005). Only 22% of mothers overall were able to perform all ten procedures completely successfully: Anapen(®) 32% and EpiPen(®) 12%. Chi-squared analysis showed a significantly higher proportion of mothers correctly performing all Anapen(®) specific procedures than EpiPen(®) (OR 14.24, p < 0.0001).
It is concerning that 15% of mothers overall could not 'fire' these devices correctly despite a one-to-one demonstration, identifying a need for more user friendly devices and training. Mothers found the Anapen(®) device significantly easier to use, which may have implications for future prescribing. Evaluation of the next generation of autoinjectors and their training packages needs to be performed as important practical differences may be found.
肌内注射肾上腺素（肾上腺素）是治疗过敏反应的一线药物，及时给药可改善预后。2011 年，英国有两种肾上腺素自动注射器，其用户的给药方法不同：EpiPen（®）和 Anapen（®）。我们对使用这些设备的所有家庭进行常规培训。
评估：在我们的标准过敏反应培训包之后，母亲使用肾上腺素自动注射器的能力。母亲发现哪种设备更容易使用。
向没有使用过肾上腺素自动注射器经验的母亲提出参与的要求。一位临床医生提供了一个随机分配的自动注射器设备的标准化演示。她立即使用十个预定标准评估母亲的表现。其中四个标准是设备专用的，六个是两个设备共有的标准。
有 100 位母亲参与：50 位使用 EpiPen（®），50 位使用 Anapen（®）。相当一部分母亲（总体 15%）无法成功“发射”这些培训设备：Anapen（®）4%，EpiPen（®）26%（OR 8.43，p=0.005）。只有 22%的母亲能够完全成功地完成所有十个程序：Anapen（®）32%，EpiPen（®）12%。卡方分析显示，Anapen（®）正确执行所有特定程序的母亲比例明显高于 EpiPen（®）（OR 14.24，p<0.0001）。
尽管进行了一对一的演示，但仍有 15%的母亲无法正确“发射”这些设备，这表明需要更便于用户使用的设备和培训。母亲发现 Anapen（®）设备使用起来明显更容易，这可能对未来的处方有影响。需要对下一代自动注射器及其培训包进行评估，因为可能会发现重要的实际差异。
