Intramuscular injection is recommended for faster adrenaline effect compared to subcutaneous. Plasma peak after 8 minutes for IM and 34 minutes for SC.2,3,4
For an IM injection, the UK Resuscitation Council guidelines for healthcare providers recommend a 25 mm needle for all ages. For small infants, a 16 mm needle is suitable.1
Short needles a problem for women and children
Epipen and Jext have needle lengths of 13–16 mm5,6, which may be too short for many adults and children.
Based on needle length only, up to 61% of children above 30 kg7,8 and up to 54% of women9,10 would not receive an IM injection with 13-16 mm needles.
Emerade has the longest needle
Emerade has a 23 mm needle for the 500 and 300 mcg dose and a 16 mm needle for the 150 mcg dose16. The longer needle increases the likelihood of an IM injection in more patients.
Important relationship between skin to muscle distance, BMI and gender
"Jext and EpiPens have insufficient needle length to administer IM adrenaline to vastus lateralis in 68% of our patient group."11 The horizontal line indicates an AAI with a 15 mm needle. The study based only on needle length. With a 23 mm needle more patients would receive an IM injection.
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