Factory packed and expired - about emergency insect sting kits

J Dtsch Dermatol Ges. 2008 Sep;6(9):729-33. doi: 10.1111/j.1610-0387.2008.06650.x. Epub 2008 Feb 11.
[Article in English, German]


Background: Patients allergic to insect venom are instructed to always carry emergency medication-an emergency kit. According to the current guidelines, these emergency kits should contain a H1-receptor-blocking antihistamine and corticosteroid for oral use, as well as an epinephrine inhaler and in particular situations an epinephrine auto-injector.

Patients and methods: For quality management reasons patients with wasp venom allergy who presented for sting challenge provocation test were told to demonstrate their emergency kits. Concomitantly, constituents of the patient's emergency kits were checked for date of expiry of the medication and the patients were interviewed on storage and use of the emergency kits.

Results: In total 42 patients with a median duration time of systemic immunotherapy of 2.5 year were evaluated. Medication post date of expiration was found in 54% of the kits (n = 39). Only 31% of the patients could demonstrate how to use the kits correctly. Problems were especially evident concerning for using the application of the inhaler and auto-injector. 50% of the patients demonstrated using epinephrine auto-injectors in such way that an accidental injection into the fingers would have resulted.

Conclusion: To assure safe and effective handling of all components of the emergency kit, continuous training and repeated supervised practice is necessary.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anaphylaxis / prevention & control*
  • Animals
  • Bites and Stings / epidemiology*
  • Bites and Stings / therapy*
  • Child
  • Drug Packaging / statistics & numerical data*
  • Drug Stability
  • Drug Storage*
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • First Aid / instrumentation*
  • First Aid / methods
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Wasps
  • Young Adult