Autoinjector or vial

Sir, we are medical emergency trainers and it has come to our attention that some practices undergoing CQC inspections in the North of England are receiving confusing information regarding adrenaline preparations that they should have in their medical emergency kits. Some practices have been advised that they should have vials of adrenaline rather than adrenaline in the form of an autoinjector preparation which is presumably due to that fact that some autoinjector preparations are only available in 300 micrograms (0.3 mL adrenaline injection 1:1000). The Resuscitation Council (UK) states that for a severe life-threatening anaphylactic reaction in an adult, 500 (micrograms (0.5 mL adrenaline injection 1:1000) should be administered into the anterolateral thigh.¹ Appendix (ii),¹ however, suggests that an autoinjector preparation delivering a dose of 300 micrograms ... is an acceptable alternative if immediately available.¹Those practices that have autoinjector preparations of adrenaline are therefore compliant with national guidelines. As medical emergency events are rare, we suggest that it is easier for dental practitioners to deliver adrenaline via an autoinjector rather than to use adrenaline from a vial.