EpiPen :: Nationwide Children's Hospital

Helping Hand Logo


Epinephrine Auto-Injectors for Severe Allergic Reaction

Epinephrine auto-injectors contain epinephrine (ep eh NEF rin). This medicine is used to treat severe allergic reactions, also called anaphylaxis (an uh ful LAK sis). When a child comes in contact with something he is allergic to, reactions usually happen fast - within 30 to 60 minutes.

When to Use

This device is used to stop a severe allergic reaction often due to a bee sting, a food or medicine. Some of the signs of a severe allergic reaction are listed below.

  • Throat: Tightness of throat, hoarse or scratchy throat, drooling
  • Breathing: Wheezing, repeated cough or shortness of breath
  • Heart: Lightheaded feeling, fainting, weak pulse, low blood pressure
  • Mouth: Swollen tongue, slurred speech or blueness around the lips
  • Skin: Severe swelling or severe itching of face, scalp, arms or legs not due to eczema (EK ze mah), or the appearance of large hives covering the body. Your child may not need epinephrine for hives alone, unless he has other signs of an allergic reaction.
  • Stomach: Vomiting two or more times or severe stomach cramps
Picture 1 - EpiPen and Auvi-Q
Image of EpiPen

There are instructions written and pictured on each injector (see Picture 1). Always have two injectors with you. Read the directions carefully when you pick up your prescription. Practice using the trainer (it does not have medicine or a needle). Know how to use it before there is an emergency. Teach anyone who cares for your child (relatives, babysitter, child care provider or teacher) when and how to use the auto-injector.
If the Auvi-Q (Audio Visual Cue) has been prescribed, it will talk you through the steps.

  1. Pull out of case.
  2. Pull off cap.
  3. Place black end firmly on outer thigh until you hear it click, then hold in place for 5 seconds. Visit the online website to review: www.auvi-q.com.

If the EpiPen or EpiPen Jr. has been prescribed, please visit the online website to review: www.epipen.com.

  1. Pull off the blue safety cap from the pen.
  2. Make a fist around the syringe so the orange tip is pointing down. CAUTION: DO NOT PUT YOUR THUMB ON THE ORANGE TIP. If the pen is upside down, you will inject yourself in the finger!
  3. With your child sitting or lying (not standing ), press the orange tip firmly against the outer thigh (Picture 2) until you hear it click. Hold it in place for 5 to 10 seconds, then remove. You can give through clothing if needed.

Important Points to Remember.

Picture 2 - Area of the thigh to insert the pen.
Image of area of thigh to insert EpiPen
  • The most common cause of death from severe allergies is waiting too long to use the epinephrine during an allergic reaction or not having the injector with you. If you have any questions, be sure to ask your child’s doctor, nurse or pharmacist.
  • Always call 9-1-1 after using epinephrine. The medicine starts to wear off in 20 to 30 minutes. The reaction may come back. Repeat the dose in 5 to 10 minutes if your child is not better. Inhalers, like albuterol and antihistamines (Benadryl®), are not usually enough to treat severe allergic reactions. You can give them after epinephrine is used.
  • Your child must sit back or lie down after the injection.
  • You must check the expiration date every month. Tell your child’s doctor or nurse when you need a refill. You can also visit the product websites to register for automatic refill reminders (www.epipen.com or www.auvi-q.com).
  • Do not store the injector in a refrigerator or a hot car. Keep it at room temperature. The liquid medicine in the injector should be clear. If it is discolored or has floating specks, get a new pen.
  • See an allergist if there has ever been a severe allergic reaction or if epinephrine has ever been needed.
  • Children who have had a severe allergic reaction should wear a medical alert bracelet or necklace (you can get it at most pharmacies).
  • If your child has a severe reaction to this medicine, call the Central Ohio Poison Center at 1-800-222-1222 (TTY 866-688-0088). They will tell you what to do.

Ask for related Helping Hands:

EpiPen (PDF)

HH-V-122 8/93, Revised 6/14 Copyright 1993-2011, Nationwide Children’s Hospital

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000