Abstract
Intramuscular adrenalin injection is the first line treatment for anaphylactic shock, and an adrenalin auto-injector (Epipen®) is commercially available in Japan. A total of 211 prescriptions were given to 117 patients from August 2005 to February 2011. The patients' age at thetime of their first prescription ranged from 2.5 to 27.8 years (median: 7.0 years). The dominant offending allergens were hen's eggs (n=56) and cow's milk (n=55). Six patients (5.1%) used the injector, four of them used it as a pre-hospital care and the others used it in the hospital. One accidental shot was reported when the injector was dropped on the floor at school. A questionnaire to the parents and the patients, who were 12 years of age or more, revealed that almost half of the patients and parents did not feel confident in their judgment of when to use Epipen®. Few patients repeatedly practiced the use of this injector at home, and nearly half of all parents did not understand whether or not there was an emergency plan including the administration of Epipen® in schools. In conclusion, precise instructions at the time of prescription, and repeated education should be emphasized for all patients that had a prescription of an Epipen®.
