Administration of adrenaline by trainee teachers in a simulated anaphylactic reaction: intramuscular versus intranasal use

Abstract

Introduction: Anaphylactic reactions represent a serious risk for children within the school environment. It is essential that teachers are prepared to respond quickly and effectively. The objective of this study was to evaluate the ability of trainee teachers to administer adrenaline, both intramuscularly and intranasally, in a simulated anaphylactic shock scenario.

Material and methods: This quasi-experimental pilot study included 23 undergraduate students in Primary Education who received training in managing severe allergic reactions. They were evaluated twice in a simulated anaphylaxis scenario. In the first test, participants chose the adrenaline device (intramuscular or intranasal). In the second, they repeated the scenario using the alternative device. Variables related to the execution of each step and the time required were recorded.

Results: More than 80% of participants correctly completed all steps with the intranasal device. However, greater difficulties appeared with the intramuscular autoinjector, particularly maintaining it in position for at least 5 seconds and massaging the area afterward, which only 20% completed. The correct compliance rate was significantly higher with the intranasal device (100% vs. 71.43%, p = 0.012), and the administration time was shorter (p = 0.022). Initially, almost 70% chose the intramuscular autoinjector, but after testing both devices, 60.9% preferred the intranasal route.

Conclusions: A brief theoretical–practical training session is effective in training future teachers to respond appropriately to anaphylaxis in schools. Participants preferred the intranasal route for its simplicity and lower invasiveness.