Updated ASCIA Adrenaline Injector Prescribing Guidelines and FAQ
ASCIA Adrenaline (Epinephrine) Injector Prescribing Guidelines and Frequently Asked Questions (FAQ) have been updated, and are now available on the ASCIA website:
Adrenaline Injectors FAQ Updated 12 January 2022
ASCIA Guidelines - Adrenaline (Epinephrine) Autoinjector Prescription Updated 12 January 2022
The main change is the inclusion of links to several publications that are consistent with ASCIA adrenaline injector dose recommendations (refer to weblinks below).
Other changes in the ASCIA Adrenaline Injectors FAQ are as follows:
- Some of the FAQs have been reordered and expanded, to address the most common questions that we have received, including FAQs 1 and 2.
- FAQ 3 includes dose recommendations and links to several publications that are consistent with ASCIA recommendations. These publications also support the use of a 500 microgram device to provide choice of dose for people over 50kg who may prefer a higher dose (500 microgram) and states that a 500 microgram device can potentially prevent the need for further doses of adrenaline.
- FAQ 8 includes ‘Students and children may be prescribed EpiPen® or Anapen® devices, and schools and CEC services need to accept both devices. Therefore, staff in schools and CEC services should be trained on both device brands.’
- FAQs 9 and 10 clarify that there are three steps to give EpiPen® and four steps to give Anapen®.
- FAQ 13 includes ‘There is no evidence that injecting the second dose of adrenaline into the same thigh is a problem. The most important thing is to give another dose of adrenaline (after 5 minutes) if symptoms persist, and phone an ambulance.’
The main changes in the ASCIA Adrenaline Injector Prescription Guidelines are as follows:
- Addition of ‘These guidelines should be used in conjunction with clinical judgement, with consideration of issues that include training on a new device and preference of device from the patient or their carer.’
- Inclusion of ‘It is important to specify brand and tick box on PBS prescription to ensure that brand is not substituted’ on the first and last page and ‘Ensure correct ASCIA Action Plan is provided for the brand of prescribed device’.
- A reordering of the dose recommendations to be on page 2, in a more prominent location than in the previous version.
- Links to several publications that support ASCIA dose recommendations, and the use of a 500 microgram device to provide choice of dose for people over 50kg who may prefer a higher dose (500 microgram) ) and a statement that a 500 microgram device can potentially prevent the need for further doses of adrenaline.
- Colour coding of the prescription guide recommendations to make them easier to follow.
- Replacement of the definitions with a link to clinical definitions in the ASCIA Guidelines for Acute Management of Anaphylaxis.
ASCIA adrenaline injector dose recommendations are based on expert consensus and standard practice by ASCIA members, which vary to the product information. These doses are consistent with the Acute Anaphylaxis Clinical Care Standard for Australia, Australian Prescriber Anaphylaxis wallchart, Australian Immunisation Handbook and international recommendations from the World Allergy Organisation (WAO), Canada and the UK (refer to weblinks below).