UK Resuscitation Council Updates Guideline on Anaphylactic Aid
Recently updated guidance from Britain's Resuscitation Council will aid health care professionals called on to provide emergency treatment of anaphylactic reactions, the London-based organization hopes. The council says a wide range of clinicians may have to treat an anaphylactic reaction, including doctors, nurses, dentists, ambulance paramedics, X-ray technicians, and others.
The council's Web site, www.resus.org.uk, provides a Q&A at www.resus.org.uk/pages/faqAna.htm to help professionals understand the updated guidelines and advise their patients. One answer explains why the council has not recommended auto-injectors for use by health care personnel:
* Auto-injectors are relatively expensive with a limited shelf life compared with the cost of an ampoule of adrenaline and syringe and needle. Anaphylactic reactions are uncommon. Most auto-injectors purchased for the health care setting will not be used.
* Auto-injectors come with standard length needle which may not be long enough to give intramuscular adrenaline for some patients.
* We have recommended a larger dose of intramuscular adrenaline (0.5 mg) for adults for use by health care providers than is delivered by the commonly available auto-injectors (0.3 mg).
* Most health care staff likely to deal with an anaphylactic reaction in the health care setting should have the skills to draw up adrenaline and give an intramuscular injection of adrenaline.
"Ultimately it is a local decision whether a health care setting opts to use auto-injectors instead of adrenaline ampoules. If there is no other form of adrenaline available, it would be appropriate for a healthcare professional to use an adrenaline auto-injector for the treatment of an anaphylactic reaction," the answer states.
The council says patients with a suspected or proven anaphylactic reaction should be offered the opportunity to be reviewed in an allergy clinic, and emergency departments should liaise with their nearest allergy clinic to ensure there is local guidance in place for the care of these patients. The council also advises there is no legal problem for anyone who administers adrenaline that is prescribed for a specific person or to an unknown person in a lifesaving situation, but "the nurse involved must work within the Nursing & Midwifery Council (NMC) standards, and must therefore be competent in being able to recognise the anaphylactic reaction and administer adrenaline using an auto-injector. Therefore it would be sensible for trusts/employers to ensure that such a provision is included in their first aid or anaphylaxis guidelines."