6345 A decade of UK accidental adrenaline auto-injector injury in children; enquiries to the national poisons information service

Le résumé fourni par la source

Objectives This study aims to evaluate all accidental adrenaline auto-injector (AAI) injuries in the U.K. discussed with the National Poisons Information Service (NPIS) between 2012–22. We identified the frequency of accidental AAI injury and the relationship of the injured party to the AAI itself. Methods A retrospective search of all telephone enquiries taken between 2012 and 2022 held on the NPIS database (UKPID) regarding accidental AAI injury was occurred. These records were analysed to extract the specific details regarding the injury, to whom the AAI belonged, the guidance provided, where it occurred, patient’s age, and presenting complaint. Results 195 telephone enquiries for patients aged 17 and under were identified. Accidental AAI injury to a digit was reported in 100 (51.3%) cases and 34 (17.4%) involved injury to the hand. In 28 (14.4%) enquiries, the AAI injury was to the lower limb. In 86 (44.1%) cases, the AAI owner was not stated. For 50 (25.6%) enquiries the AAI belonged to the patient and a further 55 (28.2%) enquiries involved an AAI belonging to a relative of the patient. For 124 (63.6%) cases a referral for medical assessment was recommended, home monitoring in 23 (11.8%) cases, and supportive care or monitoring in 32 (16.4%). In 5 (2.6%) cases the use of antidote therapy, phentolamine or phenoxybenzamine, was recommended. The NPIS comments section in the dataset highlights prolonged issues in obtaining the appropriate preparation of phentolamine for use as an antidote. 185 (94.9%) of injuries occurred in the home or domestic setting and 6 (3.1%) occurred at a school. 71 (36.4%) of patients were aged under 5 years, 72 (36.9%) 5–9 years, 40 (20.5%) 10–14 years, and 12 (6.2%) 15–17 years. The modal patient age was 3 years old, with 33 (16.9%) patients. The most reported presenting feature was ‘asymptomatic’, which was recorded in 111 (56.9%) cases. 24 (6.0%) enquiries stated injection site symptoms and another 24 (6.0%) described a symptom localised to the region injured. Conclusion AAI injuries are infrequently discussed with NPIS. There were 195 enquiries over 520 weeks, equating to on average one enquiry per two and a half weeks. Most resolve spontaneously with few needing antidote treatment for ischaemia. Improved education for families regarding storage and safe use of AAIs may reduce the incidence of accidental AAI injury.

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