University of Worcester Worcester Research and Publications

Excess Subcutaneous Tissue May Preclude Intramuscular Delivery When Using Adrenaline Autoinjectors in Patients with Anaphylaxis

Johnstone, J., Hobbins, S., Parekh, D. and O'Hickey, Stephen (2015) Excess Subcutaneous Tissue May Preclude Intramuscular Delivery When Using Adrenaline Autoinjectors in Patients with Anaphylaxis. Allergy, 70 (6). pp. 703-706. ISSN Online: 1398-9995

Full text not available from this repository. (Request a copy)


Abstract Intramuscular adrenaline is the gold standard treatment for anaphylaxis. Intramuscular injection provides more rapid and higher plasma concentrations than subcutaneous routes. Given the increasing epidemic of obesity patients are at increased risk of subcutaneous delivery, we therefore assessed the depth of subcutaneous tissue in a population of patients with anaphylaxis. Patients already prescribed adrenaline autoinjectors (AAIs) for anaphylaxis were examined with ultrasound, and measurements of skin-to-muscle depth (STMD) at anterolateral thigh and anterior thigh were performed. Twenty-eight patients (23 female, 5 male) with an age range of 18–75 took part in the study, and in 68%, the STMD was greater than AAI needle length (15.02 mm), using the anterolateral thigh as the recommended administration site. The key predictors for increased STMD were female gender (P=0.0003) and a BMI > 30 (P=0.04). AAIs require longer needles to ensure intramuscular administration, and ultrasound at point of prescription would aid needle length selection.

Item Type: Article
Additional Information:

Staff and students at the University of Worcester have access to the full-text of the online published version via the UW online Library Search. External users should check availability with their local library or Interlibrary Requests Service.

Uncontrolled Discrete Keywords: adrenaline, anaphylaxis, autoinjector, skin-to-muscle depth
Subjects: Q Science > QR Microbiology > QR180 Immunology
R Medicine > R Medicine (General)
Divisions: College of Health, Life and Environmental Sciences > School of Science and the Environment
Related URLs:
Depositing User: Stephen O'Hickey
Date Deposited: 29 Jun 2019 18:36
Last Modified: 17 Jun 2020 17:30

Actions (login required)

View Item View Item
Worcester Research and Publications is powered by EPrints 3 which is developed by the School of Electronics and Computer Science at the University of Southampton. More information and software credits.