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 Rank: Advanced Member Groups: Registered Users, Subscribers Joined: 25/05/2011(UTC) Posts: 1,270 Points: 3,810
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Hi folk I am conscious of the fact that I am often one of those dispensing advice, but I also take advice where necessary. Just doing some training with a bunch of schools staff at the moment, and an issue was raised about the epi-pen. It seems that one of the school nurses in the area has been contacting schools telling them they have to retrain all their staff in the “new method” of administration, and has been retraining them all to inject the epi-pen into the front of the thigh. I checked epi-pen’s own site today, and they have not changed their advice, and this is what we have been training – hence the query when we covered this, as a lot of the class had just had their retraining within the last few weeks. One of the full-time first-aiders from a school contacted the school nurse for me during a break; the nurse said she had received this information from the Anaphylaxis Society, with a new DVD and other stuff to back up the change. So tonight I went onto their site (http://www.anaphylaxis.org.uk) to see what I could find out. There was nothing on there about a change, and their on-line video, although describing the “draw the cross” the nurse was advocating, still seemed to show the injection in the side more than the front, although the angle of the camera could, I think, leave some scope for ambiguity. Anyone able to throw some light on this?
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 Rank: Advanced Member Groups: Forum_Moderators, Registered Users, Subscribers Joined: 27/05/2011(UTC) Posts: 1,067 Points: 3,201 Location: shropshire
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i will talk to our Paed Allergy nurse today - she trains the school nurses in our area, and see what she is doing.
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 Rank: Advanced Member Groups: Joined: 27/05/2011(UTC) Posts: 767 Points: 2,301
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I've not heard of this, but it is true that for IM injections some muscles are favoured over others. This could be a move toward a common and preferable muscle group maybe?
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 Rank: Advanced Member Groups: Registered Users, Subscribers Joined: 25/05/2011(UTC) Posts: 1,270 Points: 3,810
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Mrs T Thanks, I would be obliged, as it causes a lot of distress to students on courses when they keep hearing "That's changed, you have to learn a new way"
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 Rank: Advanced Member Groups: Forum_Moderators, Registered Users, Subscribers Joined: 25/05/2011(UTC) Posts: 1,325 Points: 3,975
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The prefered site is the upper and outer aspect of the thigh, then the upper and outer aspect of the arm. there is often confusion as some peoples language skills describe the sites differently
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 Rank: Advanced Member Groups: Forum_Moderators, Registered Users, Subscribers Joined: 27/05/2011(UTC) Posts: 1,067 Points: 3,201 Location: shropshire
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As promised I checked with out Allergy Nurse Specialist, and nothing has changed. It is still the upper outer aspect of the thigh.
http://www.alk-lifeline.co.uk/pages/home.aspx
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 Rank: Advanced Member Groups: Registered Users, Subscribers Joined: 25/05/2011(UTC) Posts: 1,270 Points: 3,810
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Thanks Mrs T. At least I can clear that up with the candidate who raised it. It brought me out in a cold sweat when she asked if I didn't know the procedure had changed. Luckily we have internet access on our phone and immediately checked epipen website. However, this school nurse had contacted her school and some others a month or so ago and told them they all had to be retrained. So the school made time and they trained 30+ staff in the "new" procedure.
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 Rank: Advanced Member Groups: Forum_Moderators, Registered Users, Subscribers Joined: 27/05/2011(UTC) Posts: 901 Points: 2,699
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oooh - scary - wonder where this nurse got her info from - scary that all of these people are now using the wrong technique - possibly doing more harm than good.
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 Rank: Advanced Member Groups: Registered Users, Subscribers Joined: 27/05/2011(UTC) Posts: 1,100 Points: 3,300
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This is strange because on a First Aid course i always cover epipen/anapen and all the staff had just had epipen training the week before and told it must be in the front of the thigh just above the knee. I said this sounded wrong to me and gave no more thought to it. This was a school in South East London.
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 Rank: Advanced Member Groups: Registered Users, Subscribers Joined: 25/05/2011(UTC) Posts: 1,270 Points: 3,810
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Our candidate was from a school in Hornchurch (London/Essex border) and that was exactly how she described (and demonstrated) it.
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 Rank: Advanced Member Groups: Forum_Moderators, Registered Users, Subscribers Joined: 27/05/2011(UTC) Posts: 1,067 Points: 3,201 Location: shropshire
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I actually went and asked our Paediatric Allergy Nurse Specilaist, and she said no, not changed. For up to date epipen training go to the Alk-Abello website - they make the epipens and do the training stuff that goes with it.
From the website The EpiPen Jr. Auto-Injectors are designed for easy use by the lay person and has to be considered as a first aid. The Auto-Injector should simply be jabbed firmly against-the outer portion of the thigh from a distance of approximately 10 cm. There is no need for more precise placement on the outer portion of the thigh. When EpiPen Jr. Auto-Injector is jabbed against the thigh, it releases a spring activated plunger, pushing the concealed needle into the thigh muscle and expelling a dose of adrenaline: 1. Grasp EpiPen Jr. Auto-Injector in dominant hand, with thumb closest to grey safety cap. 2. With the other hand pull of grey safety cap. 3. Hold the EpiPen Auto-Injector in a distance of approximately 10 cm away from the outer thigh. The black tip should point towards the outer thigh. 4. Jab firmly into the outer thigh so that the EpiPen Auto-Injector is at a right angle to (at a 90 degree angle) the outer thigh. 5. Hold in place for 10 seconds. The EpiPen Auto-Injector should be removed and safely discarded. 6. Massage the injection area for 10 seconds.
Mrs T2010-04-03 08:01:46
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 Rank: Advanced Member Groups: Registered Users, Subscribers Joined: 25/05/2011(UTC) Posts: 1,270 Points: 3,810
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Thanks again Mrs T - what would we do without you! We have not changed our advice or training, and still train from the Epi-Pen site details. But it is worrying that this is now twice this has arisen, in two different areas. Someone must be disseminating info from somewhere because School Nurses wouldn't just up and change their training on a whim. You were up and on-line early this morning!!
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 Rank: Advanced Member Groups: Forum_Moderators, Registered Users, Subscribers Joined: 25/05/2011(UTC) Posts: 1,325 Points: 3,975
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JonAcc the epi-pens come with administration directions. The directions form part of the licence for use. you may find that someone has attended a CPD Training event, and has caught a small part of what a person was saying and now wrongly believe that to be a new method of application. Stick to your current guidance and if you still have concerns, contact the head of the school nurses in your area and have a chat to them. as otherwise, you will find thios continues unchecked. regards David
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 Rank: Advanced Member Groups: Forum_Moderators, Registered Users, Subscribers Joined: 27/05/2011(UTC) Posts: 1,067 Points: 3,201 Location: shropshire
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Jonacc - 7 year old twins!!! no lie ins for me!!
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 Rank: Advanced Member Groups: Registered Users, Subscribers Joined: 25/05/2011(UTC) Posts: 164 Points: 495
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I heard off customers too that they had been taught the front of the thigh - they wouldnt believe me that it was wrong. That was in the South West Area. Scary that people are out their cleary teaching the wrong thing
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