Unintentional injection to the bone with a pediatric epinephrine auto-injector

Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
Mariam Ibrahim, Harold L Kim

Abstract

Skin-to-bone distance (STBD) in children prescribed a pediatric epinephrine auto-injector (EAI) for anaphylaxis is not commonly measured in practice. Recent evidence suggests that children with STBD less than the exposed needle length of available pediatric EAIs (dose: 0.15 mg, needle length: 12.7 mm) are at risk for unintentional injections to the bone during their use for an allergic emergency. Described here is a case of a female child with multiple food allergies prescribed a pediatric EAI (0.15 mg EpiPen Jr®) who experienced an unintentional injection to her femur. The patient's STBD at the recommended injection site (vastus lateralis) was shorter than the needle length of her prescribed EAI (12.7 mm) at the time of the injury (age: 7, height: 122 cm; weight: 25 kg), even though her weight was within the indication for this EAI (15-30 kg). The patient and her family were made aware of the risk of unintentional bone injection at the time the EAI was prescribed. Some children, even those at an appropriate weight per the indication of available pediatric EAIs (0.15 mg), may be at risk for unintentional injections to the bone. The effects of an unintentional bone injection with an EAI can have lasting effects on a child, inclu...Continue Reading

References

Aug 13, 2008·Pediatrics·William C Lippert, Eric J Wall
May 16, 2009·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·F Estelle R SimonsEric S Edwards
Feb 18, 2010·The Journal of Allergy and Clinical Immunology·F Estelle R SimonsErica L Liebelt
Aug 12, 2014·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Laura KimHarold L Kim
Oct 11, 2015·Annals of Emergency Medicine·Julie C BrownEsther Park
Mar 8, 2016·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Sten DreborgHarold Kim
Jun 9, 2016·Current Opinion in Allergy and Clinical Immunology·T Ted Song, Phil Lieberman
May 10, 2017·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Harold KimElke Platz

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Citations

Mar 6, 2021·Current Allergy and Asthma Reports·Brittany BoswellJulie C Brown

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Methods Mentioned

BETA
X-ray

Related Concepts

Related Feeds

Anaphylaxis

Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death.

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