Repeat Training Needed for Epi Autoinjectors and Asthma Inhalers

AutoinjectorA recent study from the University of Texas shows that patients frequently do not understand how to self-administer medications with epinephrine autoinjectors and asthma inhalers – considered by most to be easy-to-use medical devices.

Contrary to opinion, this study showed only 7 percent of asthma inhaler users were able to demonstrate correct use of their device. Common errors were not realizing that a horn-type sound from the spacer indicated the inhalation was performed imperfectly and not shaking the inhaler before administering the second medication puff.

In the case of epinephrine autoinjectors only 16 percent of patients with were able to demonstrate correct use. The most common error was not holding the unit in place for at least 10 seconds after triggering. Other errors included the failure to place the needle end of the device on the thigh and failure to depress the device forcefully enough to activate the injection.

Mistakes such as these is one of the reasons Iridia provides support for first responders transitioning from an EMA-FR to an Emergency Medical Responder (EMR) license level – Learn more about the EMR Program.

EMR license protocols outline the roles and responsibilities of firefighters and paramedics who respond to a medical emergency on-scene. The goal of the protocols is to quickly identify and respond to any life threatening medical emergency. Within these protocols, first responders are trained on how to use these devices correctly to support patients should they need to use an inhaler or autoinjector. 

Additionally, Iridia demonstrates proper use of these devices in our Critical Intervention Workshops, designed to review and test emergency response procedures in Non-Hospital settings such as private surgery centers, outpatient and diagnostic facilities.

It is an overlooked fact that many healthcare providers assume patients know how to use these devices. Instead, healthcare providers should take the time to understand the difficulty patients are having with these devices. Most mistakes made by users in the study would have resulted in diminished doses – impacting potentially life-saving treatment if the need arose.

“Repeated verbal instruction and, perhaps even more effective, repeated visual education, including demonstration using trainer devices, are highly recommended. Novel methods of providing this repetitive training for patients are needed,” says Dr. Bonds, author of the study.

 

Enhancing First Responder SkillSets: EpiPens

Fire Fighter FIrst Responder LicenseIn this blog series, we’re going to discuss how we’ve helped many British Columbia fire departments enhance their patient care skills in order to provide better care in the field.

Firefighters are often the first emergency response personnel on the scene of an emergency, but are not permitted to use certain medical devices, like an epi auto-injector.   When there are BC Ambulance service delays or firefighters find themselves in remote rescue scenarios, it is beneficial to the patient if firefighters have the skills to assist patients to use life-saving medications.   This is why Iridia Medical continues to support first responders improving their patient care skills.

These days, firefighters can be in direct contact with BCAS dispatchers – key information about a patient’s condition can be immediately communicated between both parties.  This removes ambiguity and allows the BCAS to monitor and guide firefighters on how to best assist a patient with their Epi-pen.  With this enhanced communication and improved skillsets, firefighters are able to provide better patient care.   “We have taken an active role in providing this training because it is the right thing to do for patients” says Dr. Allan Holmes, Founder of Iridia Medical.  “What kind of care would you want a loved one to receive during a severe allergic reaction?” is the logic behind offering epi-pen training.

Today’s example will look at how Epinephrine Auto-injectors can positively impact patient outcomes.

Epinephrine Auto-injector

Considerable educational efforts have been undertaken so that teachers, coaches, and babysitters feel confident administering epi auto-injectors.  Unfortunately, firefighters with first responder licenses are not provided the same discretion.

Iridia has been actively supporting and training fire first responders to assist patients with administering their epi auto-injectors in emergency situations.  We support fire first responders enhancing their patient care skillset because:

  • Fire first responders are often first on the scene of a medical emergency – waiting several minutes for an ambulance to administer an epi auto-injector could negatively impact the patient.
  • Currently, fire first responders and BCAS can only administer oxygen to a patient they believe is having an allergic reaction – there is no provision in their current  training program to instruct FR on how  to assist a patient with an epi auto-injector.

epi pen auto injector

In the best case scenario, the patient is lucid enough to administer their epi auto-injector.  However, if a patient is panicking and can’t self-administer the medication (or has fallen unconscious), Iridia has trained first responders to act.  Our epi auto-injector program teaches first responders how to recognize allergic reaction indicators as well as when and how an epi-pen should be used[1]; and just as important, when it should not be used – skills we believe every first responder should know.

During a serious allergic reaction every second counts.  Delaying the administration of epinephrine can have serious consequences.  Providing first responders the discretion to assist and administer epi auto-injectors when they arrive on the scene of an allergic reaction emergency has the potential to significantly improve a patient’s outcome and reduces the potential for a sometimes fatal outcome.  

[1] Upon patient consent and oversight support from BCAS dispatch.

We Can Help Enhance Your First Responder Skills

Enhancing patient care skills requires coordinating many moving parts.  Training, equipment, and a medical oversight framework need to be considered.  In addition, it’s important that fire departments understand current regulations and the limitations of their current first responder license.  Over the past decade, Iridia Medical has successfully assisted fire departments of all sizes in implementing Epi auto-injector, pulse oximeter, and blood pressure measurement programs.

To learn more, contact Jason Bradley (jbradley@iridiamedical.com), Fire Services Program Lead, to get you started.