Training of trainers on epinephrine autoinjector use

The majority of physicians do not know how to use epinephrine autoinjectors. This displays that current education of physicians on anaphylaxis is inadequate for a thorough practice. We hypothesize that a theoretical lecture together with a practical session on epinephrine autoinjector use will improve its proper use by physicians. Residents, specialists and consultants from General Pediatrics excluding allergists and allergy fellows were included in this study. All physicians were given an eight item questionnaire followed by a practical session scoring and timing ability to use epinephrine autoinjector trainer. This ensued with one to one hands-on training on correct auto-injector use. Finally, a joint theoretic lecture on anaphylaxis including re-demonstration of epinephrine autoinjector use was given. All physicians were scored a second time on use of epinephrine autoinjector 6 months later. One hundred fifty one of 196 participants completed all steps of the study in four tertiary hospitals. Correct use of epinephrine autoinjector improved from 23.3% to 74.2%, mean score from 3.49±1.14 to 4.66±0.65, need for prospectus from 91.4% to 29.1% and mean time to administer autoinjector from 28.01±6.22s to 19.62±5.01s (p<0.001 for each). The rate of most common mistakes during autoinjector use decreased but the ranking did not change. An integrated theoretic and practical education increased correct of epinephrine autoinjector use by physicians. Ongoing mistakes despite this education may be related with its design.Key words: Anaphylaxis, physician, self-injectable epinephrine, training