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Human factors engineering validation study for a novel 0.1-mg epinephrine auto-injector

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Anaphylaxis in infants and young children is increasing. Historically, epinephrine auto-injectors (EAI) were not available in a dose or platform designed for patients who weighed <15 kg, and, therefore, 0.15-mg EAIs were prescribed for these patients. Results of ultrasound studies indicate that currently marketed 0.15-mg EAIs have needle lengths that may strike bone in ∼29 to 43% of patients who weigh <15 kg and result in possible intraosseous injection. An EAI with a more weight-appropriate 0.1-mg dose and shorter needle length has been developed to potentially help minimize the risk of striking bone during epinephrine injection in patients who weigh 7.5‐15 kg.


A human factors usability study was completed to validate the 0.1-mg EAI user interface.


This study was conducted with parents of children who were severely allergic so to evaluate simulated use of the 0.1-mg EAI by the intended user group. Fifteen participants were enrolled and received training on using the 0.1-mg EAI. Approximately 24 hours later, the participants completed a simulated emergency-use scenario by using the 0.1-mg EAI with an infant manikin. The primary end point was successful simulated administration of a meaningful epinephrine dose.


All the participants simulated administration of a meaningful epinephrine dose. Fourteen participants successfully used the 0.1-mg EAI per the instructions for use in the simulated emergency-use scenario. One participant did not press the EAI against the thigh for the length of time defined for this critical task; however, the EAI was pressed long enough for complete delivery of the 0.1-mg dose.


This study validated the user interface of the 0.1-mg EAI for the intended users, uses, and use environments.

Keywords: 0.1 mg epinephrine; AUVI-Q; anaphylaxis; autoinjector; bone strike; human factors; infant; life-threatening allergy; needle length; usability study

Document Type: Research Article

Affiliations: 1: From Departments of Innovation, Development & Industrialization and Clinical Development kaleo, Inc., Richmond, Virginia 2: Core Human Factors, Inc., Bala Cynwyd, Pennsylvania

Publication date: November 1, 2018

This article was made available online on August 29, 2018 as a Fast Track article with title: "Human factors engineering validation study for a novel 0.1-mg epinephrine auto-injector ".

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

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    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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