Adrenaline Auto-Injectors (AAIs)


Any patient with a history of anaphylaxis should be referred to the Allergy Clinic at Guy’s and St Thomas’ Hospital (GSST)

A history of anaphylaxis implies that the patient has suffered form an acute collapse with any combination of bronchospasm, laryngeal/pharyngeal oedema or hypotension. This is usually but not always, accompanied by other visible features such as flushing, urticarial or angioedema


Extract from the British Society for Allergy and Clinical Immunology guidelines for prescribing an adrenaline auto-injector:

  • An adrenaline auto-injector should be prescribed for those at risk of anaphylaxis
  • After acute anaphylaxis, an adrenaline auto-injector should be prescribed in the Emergency Department or primary care and an allergy referral immediately triggered (NICE guidance)
  • Specialist allergy experience is required to make a risk assessment to determine the continuing need for an adrenaline auto-injector
  • Patients, parents or carers should be trained in both when and how to use the auto-injector device at the time of prescribing and the training reinforced when the device is dispensed by the pharmacist and during allergy clinic appointments. Pharmacists should be encouraged to undertake device training at every opportunity
  • A recent MHRA drug safety update (2014) recommended that people who have been prescribed an AAI should carry two; however, normally only one auto-injector is required for self-administration during a reaction. For children, two should usually be prescribed one each for school and for home. Exceptions, when two pens may be required in one kit, that is giving the option of administering two doses, include obesity, remoteness from medical help, a previous life-threatening reaction or if two doses were required (as distinct from given) in a short time period for previous reactions, or other assessment of risk

Advice and Guidance is being made available for all specialties, and is being provided by consultant specialists at East Kent Hospitals.  To make a request or to check to if a query has been answered, you will need to log in via the electronic Referral System (eRS)

Click here for the "how to access" e-Referral Advice and Guidance Manual for instructions on how to make a request and check responses

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