Some auto-injection pens are counterintuitive

doi:10.1136/bmj.b1303

Published 31 March 2009, doi:10.1136/bmj.b1303
Cite this as: BMJ 2009;338:b1303

Letters

Allergies hysteria is just nuts

Some auto-injection pens are counterintuitive

The first 150 words of the full text of this article appear below.

Type I allergy carries the risk of incorrect self treatment.¹In patients with type I allergy and established systemic reactions,treatment includes self injection of adrenaline with prefilleddevices—the EpiPen device is constructed to look likea ballpoint pen. Unfortunately it is constructed as an upside-downpen: the needle emerges from what at first glance seems to bethe button end of the pen, not the end where one would expectthe ink covered ballpoint tip to emerge.

Consequently, during the 2008 wasp season, we experienced twocases of adverse self injection in the thumb. Sixty seven patientswith wasp stings were seen, 16 of whom presented with systemicallergic reactions. Six of the 16 were already known to havesuch reactions and had attempted auto-injection of adrenaline.In two of the six patients, the procedure was wrongly performed:one auto-injected into the thumb, and another never receivedadrenaline because . . . [Full text of this article]

Per Lav Madsen¹, Nick Mattsson²

¹ Department of Cardiology, Rigshospitalet 2142, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark, ² Department of Internal Medicine, Nykøbing Falster Community Hospital, Denmark

per.lav.madsen@rh.dk