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Ideal body position for epinephrine autoinjector administration
Qing Wang1, Luke Pittman2, Andrew Healey3
1From the Department of Medicine, Madigan Army Medical Center, Tacoma, Washington.
Allergy and Asthma Proceedings
|March 9, 2021
Summary
Body position does not significantly alter subcutaneous tissue depth for epinephrine autoinjector administration. Prompt epinephrine delivery is recommended for anaphylaxis, regardless of patient position.
Area of Science:
- Emergency Medicine
- Pharmacology
- Anatomy
Background:
- Epinephrine is the primary treatment for anaphylaxis.
- Intramuscular (IM) injection is more effective than subcutaneous (SC) for epinephrine delivery.
- Optimal body positioning for epinephrine autoinjector (EAI) use is not established.
Purpose of the Study:
- To determine if body position affects subcutaneous tissue depth (SCTD).
- To assess the impact of body position on potential EAI delivery into the IM space.
Main Methods:
- Adult volunteers had their vastus lateralis SCTD measured using ultrasound.
- Measurements were taken in standing, sitting, and supine positions.
- Data on age, sex, and BMI were collected and analyzed.
Main Results:
- No significant difference in SCTD was found across standing, sitting, and supine positions.
- Women exhibited significantly greater SCTD than men (2.72 cm vs. 1.10 cm).
- Body mass index (BMI) did not correlate significantly with SCTD.
Conclusions:
- Body position does not appear to significantly alter the skin-to-muscle distance in the thigh.
- There may not be an ideal body position for EAI administration.
- Prompt epinephrine administration during anaphylaxis is advised in any position.
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