What is an EpiPen®?
An EpiPen®, also called an autoinjector, is an emergency device that injects a dose of adrenaline into the muscle in the leg.
Adrenaline is a naturally occurring hormone in the body and it reverses severe allergic reactions (anaphylaxis). Adrenaline is used to treat anaphylaxis and saves lives.
Should my child have an EpiPen®?
All allergists agree that children who have had a serious allergic reaction involving their breathing or poor circulation, should be prescribed an EpiPen® . The need for other children to have an EpiPen® depends on many factors which you can discuss with your doctor.
If you have an EpiPen® it is very important that you understand how and when to use it and that you have a written ASCIA action plan for anaphylaxis provided by your doctor. This plan should be kept up to date.
What is an action plan for Anaphylaxis?
An action plan for anaphylaxis is a document that describes what to do if your child has an allergic reaction and when to give the EpiPen®. A copy of this action plan can be found at www.allergy.org.au
A copy should be kept with each of your child’s EpiPens, so that if your child has an allergic reaction, you can follow the recommended actions.
You may keep a copy of your Anaphylaxis action plan on your mobile device for convenience of access. You can download the Allergy Pal app from the app store and upload the document.
Give the original to the school and keep a copy for your own use.
When should I use the EpiPen®?
The anaphylaxis action plan tells you when you should give the EpiPen®. Refer to it during an allergic reaction.
Give the EpiPen when any one of the following symptoms of Anaphylaxis are present:
- difficulty/noisy breathing
- swelling of the tongue
- swelling or tightness in throat
- difficulty talking and/or hoarse voice
- wheeze or persistent cough (Note- an important feature of all of these symptoms is that they involve the breathing passages)
- persistent dizziness or collapse pale and floppy (infants and preschool age children may become pale and floppy without other symptoms).
If you are in doubt it is better to use the EpiPen® rather than not treat a serious reaction.
What is an EpiPen® trainer?
An Epipen® trainer is a device that looks like an Epipen® but it does not have a needle or contain medicine. It is used to practice giving the Epipen®. You can obtain a free trainer by joining the EpiClub www.epiclub.com.au
Which end contains the needle?
It is important that you know that the needle is in the orange tip. You should not touch the orange tip with your fingers,
thumb or hand.
How do I use the EpiPen®?
There are 3 steps.
Remove the EpiPen® from the container. Form a fist around the EpiPen® and pull off the blue safety release cap. A useful rhyme to help you know how to hold the EpiPen® is:" blue for the sky, orange for the thigh".
2. Place the orange tip against the outer mid-thigh of the child. The mid outer thigh is the ‘fleshiest’ or meatiest part of the thigh, where the muscle is. (Note; there is no need to ‘swing and jab’) A sudden jab may cause the child to jump and the needle may be discharged before the adrenaline is injected. Hold your child securely while giving the EpiPen®. Your doctor or nurse should show you the best way to do this. The EpiPen® can be given through light clothing. If the clothing is hard to remove you should not waste time trying to do this.
3. Push HARD until you hear or feel a loud click and hold in place for 3 seconds.
The EpiPen® can only be used once. After it is used it should be given to the ambulance officers to dispose of, and should be replaced as soon as possible.
What should I do after giving the EpiPen®?
You should always call an ambulance even if the EpiPen® relieves symptoms. Your anaphylaxis action plan gives the phone number. When an EpiPen® has been used, the patient should remain under medical observation for at least 4 hours.
Is a further dose of adrenaline ever necessary?
In most cases, a single dose of adrenaline given through the EpiPen® is all that is needed. If after 5 minutes there is no response to the initial dose of adrenaline, another EpiPen® can be given if available.
What should I do if the symptoms look like Asthma?
If you are not sure if your child’s symptoms are due to allergy or asthma and you feel they may have been exposed to an allergen (e.g. food), then the safest and best course of action is to give the EpiPen®. The adrenaline in the EpiPen® will quickly treat asthma or anaphylaxis and is safe to give. An asthma reliever will not treat anaphylaxis.
Can I use other medicines (antihistamines, cortisone) instead of the EpiPen®?
No. If your child’s symptoms indicate a severe allergic reaction (anaphylaxis), you should not rely on these other medications to treat the reaction. Antihistamines do not treat or prevent anaphylaxis. Steroids take hours to work and have no role in the emergency management of anaphylaxis.
Are there side effects from using an EpiPen®?
It is very rare for children to suffer any serious side effects from an EpiPen®. The EpiPen® contains adrenaline which is a naturally occurring hormone. The skin around the injection site often becomes quite pale for a short period of time after the EpiPen® is given. Other symptoms which may occur in some cases are tremor, anxiety, palpitations, headache and nausea. These symptoms only last for a short time and are not serious.
What strength EpiPen® should I have?
ASCIA and Australian allergists recommend EpiPen® Jr for children between 7.5 and 20kg and EpiPen® for anyone over 20kg. An EpiPen® Jr is not usually recommended for children less than 7.5kg. Most children weigh 20kg before they turn 6 years old and school age children usually need the full strength EpiPen®.
Who can prescribe an EpiPen®?
The first authority prescription needs to be given by an allergy specialist, emergency specialist or a paediatrician. Your family doctor (GP) can order a repeat prescription, if the Epipen® has been used or expired, once they have information from a specialist indicating that the EpiPen® is necessary.
How many EpiPens® can I get?
The current Authority Scheme in Australia allows for up to a MAXIMUM of two EpiPens® for children and adults. Children should have one EpiPen® kept in the preschool, primary or high school office at all times and the other EpiPen® should to be carried with them at all other times, usually carried by a parent. An older child who is travelling to and from school independently should carry the second EpiPen® with them, and in High school, students should carry this EpiPen® with them all the time.
If you need more than 2 EpiPens®, extra EpiPens® can be purchased at pharmacies/chemists at the full non authority cost, without the need for a prescription. The Authority Scheme will not give more than two EpiPens®, no matter what the circumstances are.
What should I do if the EpiPen® is expired?
Replace it with a new one as soon as possible, however keep the expired device until you have a new one because in an emergency it is better to use an expired EpiPen® than no EpiPen® at all. This may still work, but not as effectively as an in date EpiPen®.
The shelf life of the EpiPen® is normally 12-18 months from the date of manufacture.
To avoid having an expired EpiPen®, mark on a calendar the expiry date, and replace before then.
Join the EpiClub www.epiclub.com.au . They will send you an email or text reminder 2 months prior to expiry date.
Should the EpiPen® go everywhere with my child?
Yes. Most reactions happen outside the home or at school. Food allergy reactions often happen in restaurants. You should have the EpiPen® and the ASCIA Action plan for Anaphylaxis with you whenever you take your child out. When your child becomes old enough to go out alone he/she should carry the EpiPen® and ASCIA action plan and know how and when it should be used.
If my child has an EpiPen® will they need it for the rest of their life?
Not always. In some cases children may outgrow their allergy, or in the case of stinging insect allergy, the allergy may be successfully treated by desensitisation and eventually an EpiPen® may not need to be carried.
How should I store the EpiPen®?
The EpiPen® should be stored in a cool place at room temperature - but NOT refrigerated. Keep the EpiPen® in a place where it is readily available if you need to use it. Never lock the EpiPen® away e.g. in a high school locker.
Where can I find more information?
- The Australian Society of Clinical Immunology and Allergy (ASCIA) website: . It also has a comprehensive e-learning program.
- The patient support group Allergy and Anaphylaxis Australia: www.allergyfacts.org.au
- AllergyPal is an electronic record of a child’s ASCIA allergy plan: www.mcriallergypal.com.au