What dose of adrenaline auto-injector should schools obtain / healthcare professionals prescribe?

A number of different brands of AAIs are currently available in the UK, in different doses:

  • Emerade: 150, 300 and 500 microgram doses available
  • Epipen: 150 and 300 microgram doses available. Epipen Junior delivers a 150 microgram dose
  • Jext: 150 and 300 microgram doses available

Schools may wish to purchase the brand of AAI most commonly prescribed to its pupils, to reduce confusion and assist with training. The decision as to how many devices and which brands to purchase will depend on local circumstances, and is left to the discretion of the school. Schools may wish to seek appropriate medical advice when deciding which AAI device(s) are most appropriate.

When healthcare professionals prescribe AAIs, this is done according to each child’s individual weight:

  • 7.5–25 kg: 150 microgram (0.15mg) dose. Emerade 150 is not recommend in children under 15kg.
  • More than 25 kg: 300 microgram (0.3mg) dose.

Emerade also market a 500 microgram dose which is recommended for people over 60kg, although many specialist centres will recommend Emerade 500 for anyone over 45kg.

However, in the context of supplying schools with AAIs for emergency use (rather than for individuals), schools may wish to use the following guidance from the Department of Health:

For children age under 6 years:For children age 6-12 years:For teenagers age 12+ years:
• Epipen Junior (0.15 mg)
or
• Emerade 150 microgram
or
• Jext 150 microgram
• Epipen (0.3 milligram)
or
• Emerade 300 microgram
or
• Jext 300 microgram
• Epipen (0.3 milligram)
or
• Emerade 300 microgram
or
• Emerade 500 microgram
or
• Jext 300 microgram

NB: These age-based dose recommendations are consistent with the UK Resuscitation Council guideline for the management of anaphylaxis by healthcare professionals.

The needle length varies from device to device. Healthcare professionals have the option of prescribing a larger or smaller dose following clinical assessment of each individual patient. For more information, see the MHRA review of adrenaline auto-injector devices.

Posted by

Comments are closed.