Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what the most up to date NHS advice is for the application of a second Adrenaline Auto-Injectors in an anaphylactic emergency.

While adrenaline auto-injectors (AAIs) are prescription only medicines, given by intramuscular injection, regulation 238 of the Human Medicine Regulations 2012 allows anyone to administer adrenaline for the purpose of saving a life in an emergency. This includes first-aid responders, although this does require the patient to have their AAI with them.

The decision to administer adrenaline is always subject to the pharmacist’s professional judgement. If a pharmacist administers adrenaline, they must also dial 999 for an ambulance, reporting a case of suspected anaphylaxis.

In June 2023, the Medicines and Healthcare products Regulatory Agency (MHRA), with the support of allergy awareness advocates, launched a safety campaign to raise awareness of anaphylaxis and provide advice on the use of AAIs. The MHRA produced a toolkit of resources for health and social care professionals to support the safe and effective use of AAIs. Alongside this, the MHRA produced guidance, which states that prescribers should prescribe two AAIs to make sure patients always have the second dose and that those who are prescribed AAIs should carry two AAIs at all times.