SHEFFIELD CLINICAL IMMUNOLOGY AND
ALLERGY SERVICE
These constitute guidelines for the diagnosis/management of the condition stated, for use by immunology
doctors and nurses within the Sheffield Clinical Immunology and Allergy Service.
Clinical judgement supersedes these guidelines whenever necessary.
GUIDELINES FOR:
PATIENT INFORMATION SHEET; HOW AND WHEN TO USE
THE ADRENALINE AUTOINJECTOR
Gone to medical illustration
Index No:
AL 78
Name,
Designation
Approved for
local use at this
centre by:
Version No:
Date
AL 78.04
Signed
Dr Egner/ Dr
Shrimpton/ Dr
Sargur
Consultant
Immunologists
Date operational:
Date for review:
NOVEMBER 2012
NOVEMBER 2014
Filename:
Status:
Location of copies on this site:
Operational /Controlled
This is copy number:
Summary of changes compared to
previous version:
Copy 1: Immunology Office CIAU
Copy 2: Shared Drive Limited Access
Copy 3: Nursing Station CIAU
This is the fourth version
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CLINICAL IMMUNOLOGY AND
ALLERGY SERVICE
HOW, AND WHEN, TO GIVE ADRENALINE USING AN AUTOINJECTOR
FOR ALLERGIC REACTIONS
Anaphylaxis is an acute severe reaction needing immediate medical attention. You
may feel as if you cannot breath or are about to collapse. The treatment is injected
adrenaline [see treatment plan].
Minor or Moderate allergic reactions can have some of the same symptoms but are much
less severe and may be treated with antihistamines, salbutamol, inhaled adrenaline or
corticosteroids as required [see treatment plan]. Adrenaline is not needed for minor or
moderate reactions.
When someone develops an acute allergic reaction the onset is usually rapid (usually less
than one hour after exposure, often within minutes.)
MINOR symptoms may include:




Itching
Strange or metallic taste in the mouth.
Urticaria (Hives, Nettle Rash) anywhere on the body. [Urticarial rash is pale pink,
raised and intensely itchy].
Swollen lips, tongue or face.
MODERATE TO SEVERE symptoms may include:



Difficulty in swallowing due to swollen throat or tongue
Mild or moderate difficulty in breathing due to a swollen tongue, or because of
wheezing/asthma.
Abdominal pain, cramps or diarrhoea.
SEVERE symptoms may include:

Rapid onset of severe difficulty in breathing due to wheeze or throat swelling
and/or a sudden feeling of
o
o
o
o
Severe faintness
Actual collapse
Loss of consciousness
Low blood pressure
For further information contact:
Sr. Fran Ashworth, EN, RGN, ONC, BA [Hons], DCHCP
Tel 01142 266964 or 01142 434343 Bleep 2918.
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CLINICAL IMMUNOLOGY AND
ALLERGY SERVICE
DIRECTIONS FOR USING AN ADRENALINE AUTOINJECTOR
(e.g. JEXTTM OR EPIPENTM)
If you experience symptoms suggesting a severe reaction you should take the
following actions IMMEDIATELY.
1. Send someone to call an Ambulance.
Say the problem is “ANNA-PHIL-AXIS”
2. Lie down if you feel faint. If someone else has collapsed then position them on their
side in Recovery position. Never sit upright until medically assessed, leave
others lying down.
3. Place the black tip of the adrenaline autoinjector (the pointy bit) against the big muscle
on the front or side of the patient’s thigh, holding the autoinjector at right angles to
the leg.
4. Remove the grey or yellow safety cap.
5. Press hard and steadily into the thigh until the autoinjector mechanism functions; [you
will hear a click] - hold in place for 10-15 seconds.
6. Remove the autoinjector from the thigh, massage the injection site for several
seconds. Note the time.
7. Elevate the legs; Do not sit the patient up (even if they feel better)
8. If someone else has collapsed check their pulse and breathing. If necessary perform
Cardio Pulmonary Resuscitation [CPR] immediately and continue to do so until the
ambulance arrives or the patient recovers.
9. Check the Ambulance has been called.
10. Stay with and reassure the patient if recovering or continue CPR until help arrives if
the patient is not recovering and consider giving a second autoinjector (if available)
after 5-15 minutes if there is no sign of recovery. This is rarely needed.
Side effects of adrenaline may include:
Palpitations, tachycardia [rapid pulse], sweating, nausea, and vomiting, pallor,
dizziness, nervousness and anxiety.
In people with ischaemic heart disease [IHD] adrenaline may induce angina or rarely a
heart attack. Adrenaline should be reserved for severe reactions in these patients.
IF IN DOUBT AND FACED WITH SIGNIFICANT DIFFICULTY IN BREATHING, OR
IMMINENT COLLAPSE DUE TO ALLERGY - USE THE ADRENALINE
AUTOINJECTOR.
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CLINICAL IMMUNOLOGY AND
ALLERGY SERVICE
DIRECTIONS FOR USING AN ADRENALINE AUTOINJECTOR
1. Remove autoinjector from its
carton.
2. Place black tip onto the thigh
at right angle to the leg
3. Remove grey or yellow
safety cap and press hard
into thigh until autoinjector
mechanism functions. Hold
in place for 10 seconds.
4. The autoinjector should be
removed and discarded
safely
5. Massage the area for
several seconds.
Grey or yellow
safety cap
Black tip
NB ONCE USED, THE AUTOINJECTOR NEEDS TO BE DISCARDED IN A SAFE MANNER.
IT IS ADVISED TO GIVE THEM TO AMBULANCE OR HOSPITAL STAFF WHO WILL
DISCARD THEM FOR YOU.
NEVER SIT THE PATIENT UP, EVEN IF THEY FEEL BETTER, UNTIL ASSESSED BY A
PARAMEDIC OR DOCTOR. THIS CAN BE DANGEROUS.
IF BLOOD PRESSURE APPEARS LOW, ELEVATE (LIFT UP) THE LEGS.
For further information please consult the appropriate website:
www.epipen.co.uk
www.jext.co.uk
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