Background Anaphylaxis is a severe life threatening allergic reaction. Prompt administration of epinephrine(adrenaline) is the first line treatment. There are currently three epinephrine auto-injector devices available in the UK; original Anapen, new EpiPen and Jext, each of which differ in their advised method of use. International standards recommend training for all patients prescribed epinephrine auto-injectors, we meet these. If families can more successfully use a particular trainer device, this may have important clinical effects.

Aims To assess the effectiveness of the training by evaluating “epinephrine naive” families’ ability to successfully use an auto-injector trainer device.

Methods Adults and children over 12, with no experience of auto-injector use were invited to participate in this service evaluation. They were randomly allocated to be trained in the use of one of the available auto-injectors. Their performance was assessed using a ten point marking sheet based on the correct method of administration of epinephrine for the individual device. Six marks were for procedures identical to all three devices (e.g. massage the site of injection) and four were device specific to reflect the differences in administration technique. Success rates were analysed by Chi-square with p < 0.05 being deemed significant (http://graphpad.com/quickcalcs/contingency 2).

Results There were 120 participants.

Conclusions Only 28% of participants were able to perform the individual device’s 10 steps correctly. Overall the trainer devices fired in 88%, with a failure rate of 2 to 30%; a clinically and statistically significant result. The Epipen’s swing and hit delivery method may affect its successful delivery compared to the Jext and Anapen’s methods.