Evaluation of access to adrenaline in different non-operative clinical areas-A Blind Study

Background: It’s vital to have quick access to adrenaline injection.The impulse for carrying out this study stemmed from the fact that there was an observational variation in responding to and conducting the management of... [ view full abstract ]

Background: It’s vital to have quick access to adrenaline injection.The impulse for carrying out this study stemmed from the fact that there was an observational variation in responding to and conducting the management of critical incidents by resident in different wards of the hospital.
Objectives: evaluate the access to the prototype drug,adrenaline injection in non-operative clinical areas.
Method: The study was undertaken in five non-operative clinical areas namely Emergency, Medical,Surgical,Obstetrics and Orthopaedics wards of this teaching hospital.Ten teams to five different wards were sent simultaneously check response of duty residents to pick up Adrenaline injection in any form (PFS pre-filled syringes or ampoules) at the nursing station and hand it over to the auditor. Access time in getting ampoules/prefilled syringe in seconds was measured by stop watch.
Results: Mean time to access adrenaline was least in A&E ward (22.20 sec) while highest in Medicine ward (38.00 sec).In medicine it showed the highest variability (21.6%) in time while Obstetrics the least (9.3%). On comparing the time, the mean time to access adrenaline in medicine was found to be significantly (p0.05) than other wards.
The time to access adrenaline was further studied according to its procurement in either ampule(AMP) or Prefilled syringe form (PFS).It was found that time to access the adrenaline in Ampoule form was least in A & E (24.33 ± 3.67 sec) while highest in medicine(32.17 ± 3.66 sec). Similarly, the time to access the adrenaline in Prefilled syringe form was least in A&E (19.00 ± 2.71 sec) while highest in Obstetrics ward (23.50 ± 1.00 sec). It was also observed that mean time to access PFS were less than ampule in each group.

Conclusion: We conclude that access to adrenaline injection was significantly shorter in the A&E but it was significantly higher in other wards. The access to pre-filled syringes was quicker than the ampules therefore it is advisable to place “adrenaline” in clearly demarcated area with colour coded illuminated signmarks and preferably pre-filled syringes.