@article {Pike54, author = {Louise Charlotte Pike and David Tuthill}, title = {Service evaluation of laceration risk using trainer adrenaline auto-injectors}, volume = {106}, number = {1}, pages = {54--57}, year = {2021}, doi = {10.1136/archdischild-2020-318898}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objective Anaphylaxis is a severe, potentially fatal allergic reaction best treated with intramuscular epinephrine via epinephrine auto-injectors (AAIs). Our published concerns over laceration injuries to young children associated with AAIs led to this service evaluation of the two administration methods: swing and jab (S\&J) and place and press (P\&P), to determine potential laceration risk.Design A trainer EpiPen was used with facepaint placed in the needle indentation which would record the length of movement of the AAI. The two different methods {\textquoteleft}administered{\textquoteright} were alternated. Children were asked to move their leg to simulate a withdrawal reaction. Age, whether they moved, and length of paint mark were recorded.Setting Outpatients waiting area in Noah{\textquoteright}s Ark Children{\textquoteright}s Hospital, Cardiff.Participants Children aged 5{\textendash}11 with no prior knowledge of AAI use.Intervention No intervention was implemented.Results 135 children (mean age 8 years; range 5{\textendash}11 years) were asked to participate; measurements were taken from 100 children. 50 children moved for one or both methods. For those that moved, S\&J mean paint length=8.3 mm (SD 17.4, 95\% CI 3.4 to 13.3), P\&P mean=3.5 mm (SD 11.0, 95\% CI 0.4 to 6.6). Mean difference between methods was 4.8 mm (SD 10.1, 95\% CI 1.9 to 7.7). Slightly more children moved for S\&J (44) compared with 38 for P\&P.Conclusions S\&J produces more movement and longer paint marks than P\&P. The risk of laceration when administering an EpiPen to young children may be lower by using the more controlled P\&P. We feel it is advisable to teach P\&P instead in children below 11 years of age.}, issn = {0003-9888}, URL = {https://adc.bmj.com/content/106/1/54}, eprint = {https://adc.bmj.com/content/106/1/54.full.pdf}, journal = {Archives of Disease in Childhood} }