Premium
BSACI guideline: prescribing an adrenaline auto‐injector
Author(s) -
Ewan Pamela,
Brathwaite Nicola,
Leech Susan,
Luyt David,
Powell Richard,
Till Stephen,
Nasser Shuaib,
Clark Andrew
Publication year - 2016
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.12788
Subject(s) - guideline , medicine , medical prescription , anaphylaxis , dosing , allergy , intensive care medicine , randomized controlled trial , scientific evidence , family medicine , pharmacology , surgery , immunology , pathology , philosophy , epistemology
Summary This guidance for the prescription of an adrenaline auto‐injector has been prepared by the Standards of Care Committee ( SOCC ) of the British Society for Allergy and Clinical Immunology ( BSACI ). There is insufficient quality evidence‐based data in some areas, including the question of how often a second dose is required, and the optimal dose and absorption after subcutaneous vs. intramuscular injection. Thus, indications for adrenaline (which are partly opinion based) in guidelines from different countries vary slightly. The guideline is based on evidence as well as on expert opinion and is for use by both adult physicians and paediatricians practising allergy. During the development of these guidelines, all BSACI members were included in the consultation process using a web‐based system. Their comments and suggestions were carefully considered by the SOCC . Evidence from randomized controlled trials is lacking in anaphylaxis for ethical reasons. Consensus was reached by the experts on the committee. Included in this guideline are aetiology, risk of recurrence and management of anaphylaxis (after treatment of the acute episode), including allergen avoidance and written treatment plans. There are sections on dose and absorption of adrenaline, and adrenaline auto‐injectors, including indications for their prescription, risk assessment for the number required and training in their use. The guidelines are not intended to be prescriptive, and clinicians should use their clinical judgement. Finally, we have made recommendations for potential areas of future research.