Retrieval of Additional Epinephrine from Adrenaclick-Style Epinephrine Autoinjectors

Retrieval of Additional Doses of Epinephrine From the New Teva Epinephrine Autoinjector Pen

Epinephrine autoinjectors are commonly used in urban environments for anaphylaxis. In remote environments, the effects of a single dose of epinephrine may diminish before one can access higher medical care. By retrieving additional epinephrine from common autoinjectors, a medical provider may be able to treat or delay decompensation of anaphylaxis in the field during evacuation. The new Teva epinephrine autoinjectors were obtained. The design of the mechanism was researched by studying patents and disassembling trainers and medication-containing autoinjectors. Multiple methods of access were tried to find the quickest, most reliable method that required minimal tools or equipment. A quick, reliable method of removing the injection syringe from the autoinjector using a knife was determined, as outlined in this article. The syringe plunger had a security design to prevent dispensing further doses from the syringe, so a long narrow object is also required to dispense additional doses. There are 4 additional doses of approximately 0.3-mg epinephrine in these Teva autoinjectors. Prior knowledge of epinephrine equipment and the devices that may be encountered in the field is important for providing life-saving medical care. The ability to retrieve additional doses of epinephrine from a used autoinjector can provide additional life-saving medication while evacuating to a higher level of medical care. This method does carry risks to rescuers and patients; however, it can potentially be life saving.

Symjepi Epinephrine Injection Device Deconstruction and Residual Medication Retrieval in an Austere Environment

Epinephrine is the primary therapy in the treatment of anaphylaxis. Epinephrine delivery devices are commonplace in out-of-hospital care of anaphylaxis because they administer a standardized dose of epinephrine, limit human error, and allow for ease of use by the operator. However, a major limitation of these devices is the single-use nature of the products. In an austere setting, the ability to obtain additional doses from an autoinjector may prevent further progression of anaphylaxis. Previous articles have demonstrated the deconstruction of spring-loaded epinephrine autoinjectors to extract additional medication doses. This article provides instruction and videography, outlining the process of deconstructing and obtaining additional doses of epinephrine from the Symjepi prefilled syringe.

Single-Drop Analysis of Epinephrine and Uric Acid on a Screen-Printed Carbon Electrode

This work demonstrates the analysis of epinephrine (EP) and uric acid (UA) in a single drop (the volume of the test solution was only 50 µL) using a screen-printed carbon electrode (SPCE) sensor and square-wave voltammetry (SWV). The limit of detection, limit of quantification, linearity, accuracy, precision, and robustness were validated. The normality of the experimental data was tested and confirmed for both methods. Heteroscedasticity was checked by residual analysis followed by a statistical F-test. The latter was confirmed for both analytes. The low relative standard deviations (RSD) at all calibration points and repetitive slopes justified the use of a calibration curve; therefore, the standard addition methodology was avoided (the latter is common in electroanalysis, but time-consuming). Since the conditions for using an ordinary least squares (OLS) regression were not met, weighted linear regression (WLR) was used to improve the accuracy of the analytical results at low concentrations of the analytes. In this manner, the best weighted model was determined and used for the quantification. A comparison was made between the OLS and WLR methods to show the necessity of using the WLR method for EP and UA analysis. The newly developed and validated methods were also shown to be effective in the analysis of real samples. The content of EP in an EP auto-injector and UA in human urine was tested by employing the best weighted model. For EP and UA, the accuracy in terms of the average recovery value was 101.01% and 94.35%, and precision in terms of RSD was 5.65% and 2.75%, respectively. A new analytical methodology is presented that uses a low volume (a single drop), and it offers the advantage of electroanalysis for on-site analysis, where conventional chromatographic techniques cannot be easily employed. Furthermore, the developed technique has additional advantages in terms of speed, cost, and miniaturization.