Nuts! I Can’t Figure Out How to Use My Life-Saving Epinephrine Auto-Injector!

Abstract

Background

Epinephrine auto-injectors for food allergy emergency treatment is used as a case study to illustrate how human factors in device design has an impact on proper management of anaphylaxis. Because timely injection is so crucial, epinephrine comes in preloaded syringes or auto-injectors that patients can carry with them. However, many factors influence whether treatment is carried out properly.

Human Factors Engineering (HFE) Analysis

The incidence of incorrectly using auto-injectors is not isolated; studies have shown that a significant proportion of patients, and even physicians, do not know how to correctly use the devices. Some auto-injectors appear to be modeled with a metaphor in mind (a pen), but they do not appear and operate consistently with the metaphor. In addition, the device is difficult to transport. The portability issue creates a challenge that cannot be adequately addressed with traditional intervention measures—reminders or more education. They are all human factors issues and require human factors-based interventions.

Summary

Although education and training in how to use an auto-injector are important for effective management of anaphylaxis, a poorly designed device can lead to incorrect operation of such a device. HFE can improve device design so that it is reliably and correctly used even with minimal training. Manufacturers, allergists/immunologists, and pharmacists all have critical roles to play to ensure the correct use of this life-saving device.