> Sanofi US Issues Voluntary Nationwide Recall of All Auvi‑Q® Due to Potential Inaccurate Dosage Delivery > ... > If a patient experiencing a serious allergic reaction (i.e., anaphylaxis) did not receive the intended dose, there could be significant health consequences, including death because anaphylaxis is a potentially life‑threatening condition. As of October 26, 2015, Sanofi has received 26 reports of suspected device malfunctions in the US and Canada.
Or is it something that somebody like an EMS would probably not get wrong, but say, a non-medically trained panicked parent could?
I've heard the shelf-life complaints about Epipens.
For me, I figured it was pretty idiot proof, even for an untrained person in panick mode - take it out, stab it in leg, and that's it, as opposed to trying to drain an ampoule into a syringe. Fortunately, I've never had to face that bad situation....
There are some things that can be done to improve the effectiveness of EpiPen/equivalent administration - while the product is designed to be able to be used through clothing, it is better to be removed where possible. Due to the dosage size, post injection site massage is recommended for better uptake from the muscles.
When to administer is also another question - arguably by the time the patient is in significant respiratory distress, it should have been administered earlier. This can be a balancing act between a 'sensitivity' and anaphylaxis. Realistically, as soon as there is a deterioration into multi-system response, Epi should be administered.
Certainly, other than cost there's no real motivator for the lay person to need to be trained to draw up epi into a syringe. But in terms of ambulances / medic units who stock epi (typically used in cardiac arrest), the requirement to stock EpiPens is an unneeded redundancy, and an expensive one at that.
"Wrong dosage", though? Dosing epi isn't a particularly exact science - the adult pen is 0.3mL, the junior 0.15mL. Quite often we will have to use multiple pens on the one patient.
Underdose is entirely common - especially in civilian-administered situations. Overdose is typically restricted to acute hypertension and associated symptoms which can largely be managed by EMS (who should be enroute anyway for any admin of epi, for reasons not least of which include that 'need for additional dose').