Epinephrine Auto-Injector Appears Safe in Paediatric Patients Weighing Less Than 15 kg

November 27, 2018

By Nancy A. Melville

SEATTLE, Wash -- November 26, 2018 -- Paediatric patients weighing

“Patients less than 15 kg tolerate intramuscular epinephrine without serious adverse events, even in doses well above the recommended 0.01 mg/kg,” reported Jennifer Jensen, Seattle Children’s Hospital, Seattle, Washington, and colleagues. “These findings support the use of 0.15 mg epinephrine auto-injectors in this population when lower-dose auto-injectors are unavailable.”

The researchers conducted a retrospective study of 227 patients weighing

Among the patients, 111 (48.9%) with a mean age of 1.78 received pre-arrival epinephrine. Those patients received a mean of 1.2 administrations pre-admission. Upon admission, 59% were re-dosed.

The remaining 116 (51.1%) patients, with a mean age of 1.48 years, did not receive pre-arrival epinephrine, but did require epinephrine upon arrival in the emergency department or urgent care centre, with a mean of 1.1 administrations of epinephrine overall.

Of the patients receiving pre-arrival epinephrine, 15% received an initial dose exceeding 0.15 mg/kg, and 31% required more than 1 dose; however, they did not differ in exam findings from those who received only 1 dose.

While pre-arrival epinephrine was associated with more vomiting after the initial dose (P

The authors noted that the increased vomiting that was observed in the pre-admission epinephrine group may not necessarily have been associated with the higher epinephrine dose.

“Given that 31% of children receiving pre-admission epinephrine also received additional epinephrine [at the emergency department], the symptom of vomiting may have reflected more severe disease rather than a side effect of the epinephrine,” the authors explained.

[Presentation title: Impact of Pre-Arrival Epinephrine in Emergency Department or Urgent Care Pediatric Anaphylaxis Patients Weighing