EpiPen :: Nationwide Children's Hospital

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The EpiPen® (EH pee pen) and EpiPen® Jr are “auto-injector pens”. The pen contains epinephrine (ep eh NEF rin). This medicine is used to treat severe allergic reactions, also called anaphylaxis (an uh ful LAK sis). After a child comes in contact with something he is allergic to, reactions usually happen fast - within 30 to 60 minutes.

When to Use the EpiPen

The epinephrine pen is used to stop a severe allergic reaction to a bee sting, a food or medicine. Use the EpiPen If your child shows any of the signs of a severe allergic reaction listed below.

Picture 1 - Parts of the EpiPen.
Image of EpiPen
  • Lungs: Chest tightness, cough or sneezing that will not stop, wheezing, or shortness of breath
  • Heart: Lightheaded feeling, fainting, weak pulse, low blood pressure
  • Throat: Tightness of throat, hoarse or scratchy throat, drooling
  • Mouth: Swollen tongue, swollen lips, slurred speech or blueness around the lips
  • Skin: Swelling or severe itching of face, scalp, arms or legs not due to eczema, (EK ze mah) or the appearance of large hives on the body. Epinephrine may not be needed for hives alone, unless your child has other signs of an allergic reaction.
  • Stomach: Vomiting 2 or more times, severe stomach cramps or diarrhea

Watch your child very closely for the above symptoms. Even if your child shows none of these signs that in the past caused an allergic reaction, have the EpiPen ready to use (Picture 1).

How to Use the EpiPen

Instructions are written and pictured on each pen. Keep 2 pens available. Read the directions carefully when you pick up your prescription. If your child is old enough to use the EpiPen himself, have him practice using the trainer pen that does not have medicine or a needle. Both of you will know how to use it before there is an emergency.

  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. Hold orange tip near outer thigh, swing and press firmly against the outer thigh until you hear it click. Hold it in the thigh for 10 seconds (Picture 2). It can be given through clothing if necessary.
  4. Remove EpiPen from the thigh and massage the injection site for 10 seconds. The orange needle cover will now cover the used needle.
  5. Call 911.

Important Points to Remember

  • Always call 9-1-1 after using epinephrine. The medicine starts to wear off in 20 to 30 minutes and the reaction may come back.
    Picture 2 - Area of the thigh to insert the pen.
    Image of area of thigh to insert EpiPen
  • Your child must sit back or lie down after the injection.
  • Repeat the dose in 5 to 10 minutes if your child is not improving. Inhalers, such as albuterol and antihistamines (Benadryl®), are not usually enough to treat severe allergic reactions. They can be given after epinephrine is used if available.
  • Be sure to teach anyone who cares for your child (teacher, child care provider, baby-sitter, relatives) when and how to use the auto-injector.
  • It is your responsibility to check the expiration date every month. Tell your child’s doctor or nurse when a refill is needed. You can also visit www.epipen.com to register for automatic refill reminders.
  • Do not store the pen in a refrigerator or a hot car. It should be kept at room temperature. The liquid medicine in the pen should be clear. If it is discolored or has floating specks, get a new pen.
  • Your child should see an allergist if he has ever had a severe reaction or if epinephrine has ever been needed.
  • Most children, who have had a severe 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.

The most common causes of death from severe allergies are waiting too long to use the EpiPen during an allergic reaction or not having a pen available. If you have any questions, be sure to ask your child’s doctor, nurse or pharmacist.

Ask for related Helping Hands:

EpiPen (PDF)

HH-V-122 8/93, Revised 3/11 Copyright 1993-2011, Nationwide Children’s Hospital

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