Unintentional injections are delivered to a finger or thumb around 90% of the time they cause intense pain locally but usually completely resolve. The rate of unintentional injections using these devices is unknown but a 2009 review found that the rate is increasing.
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People to whom epinephrine autoinjectors are prescribed need to be trained how to use the specific device prescribed. The devices contain a fixed dose of epinephrine and a spring-loaded needle (or, in the case of AuviQ, a CO 2-driven needle) that exits the tip or edge of the device and penetrates the recipient's skin, to deliver the medication via intramuscular injection. Needle exits through a protective barrier when this is pressed against the skin. Later springs back to cover the needle after use. When retracted upward (left) exposes the needle and triggers the latch mechanism. Loaded spring that drives the plunger and the needle (toward the right). Four latch mechanisms that hold the plunger secure. The inner mechanism of an epinephrine autoinjector. A study in rabbits showed that intramuscular epinephrine has decreased effectiveness after it expires that study also recommended that if the drug in an expired device has not started to precipitate (if the solution is not cloudy and has no particles in it) using the expired device is better than no injection at all in an emergency situation. The epinephrine in autoinjectors expires after one year. Minor adverse effects from epinephrine include tremors, anxiety, headaches, and palpitations.
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The intramuscular route is preferred over subcutaneous administration because the latter may have delayed absorption. It is not clear which are the people who might need a second injection at the outset. A second dose is needed in 16–35% of episodes with more than two doses rarely required in around 80% of the cases where a second dose is administered, it is by a medical professional. The injection may be repeated every 5 to 15 minutes if there is insufficient response. When anaphylaxis is suspected, epinephrine solution should be given as soon as possible as an intramuscular injection, in the middle of the outer side of the thigh, which corresponds to the location of the vastus lateralis muscle. ALK Pharma Jext300, adrenaline autoinjector, without its safety coverĮpinephrine autoinjectors are hand-held devices carried by those who have severe allergies the epinephrine delivered by the device is an emergency treatment for anaphylaxis.