Using an Epinephrine Auto-Injector: How to Care for Your Child

Epinephrine is a first-aid medicine for serious allergic reactions (anaphylaxis). This medicine is easy to carry and use. Your child should have two epinephrine auto-injectors available at all times.

Your health care provider prescribed epinephrine because your child is at risk for a life-threatening allergic reaction, called anaphylaxis. Epinephrine comes in an auto-injector. There are different types of auto-injectors, such as EpiPen® and Auvi-Q®.

Your child should use an epinephrine auto-injector right away if symptoms of a serious allergic reaction develop. Symptoms may include:

• trouble breathing, swallowing or speaking

• tightness in the throat

• swollen tongue or lips

• a hoarse voice

• wheezing

• coughing

• vomiting

• feeling lightheaded or fainting

• many hives on different parts of the body or widespread redness

• a combination of two mild symptoms, like a few hives with nausea 

Here are some things to keep in mind about epinephrine auto-injectors:

• Fill the prescription for the auto-injectors right away.

• Epinephrine auto-injectors usually come in a two-pack. Keep both auto-injectors together because your child should have two epinephrine auto-injectors nearby at all times. This is in case one injector does not work or your child needs another dose of epinephrine before help arrives in an emergency.

• Your health care provider may prescribe extra sets of epinephrine auto-injectors to keep at school, at home, and with your child.

• Store the medicine away from light (for example, in a small bag) and at room temperature. Do not refrigerate the epinephrine and do not allow it to get hot.

• Check the expiration date on the auto-injectors regularly. If any injector is about to expire, call your health care provider to have the prescription refilled.

• Check the liquid in the epinephrine auto-injectors once a month. To do this, look in the small window on the auto-injector. The liquid in the epinephrine auto-injectors should be clear. If the fluid is colored or cloudy, or if it contains particles, call your health care provider to have the prescription refilled.

To use an epinephrine auto-injector:

1. If possible, lay your child down. If not, have your child sit down.

2. Remove the auto-injector from its case.

3. Remove the safety release cap(s).

4. Firmly grasp the auto-injector in your hand. Keep your fingers and thumb away from both ends of the injector.

5. If you have A pen-shaped auto-injector (EpiPen® or generic):

   • Hold your child's leg still, and use a swinging motion to firmly push the orange or red end of the auto-injector into the middle of your child's outer thigh until you hear a click. (You do not need to remove your child's clothes. The needle can go through clothing.)

   • Follow the auto-injector's instructions on how long to hold the device in place (for example, an EpiPen® is held for 3 seconds, but some generic injectors are held for 10 seconds), then remove. Massage the thigh area for 10 seconds.

6. OR if you have: An Auvi-Q®:

   • Place the black end against the middle of your child's outer thigh and press firmly so that you hear a click. (You do not need to remove your child's clothes. The needle can go through clothing.)

   • Hold the Auvi-Q® in place for 2 seconds, then remove.

7. Call 911 and tell them your child is having a life-threatening emergency.

8. If your child is not already lying down, lay him or her down and raise the legs.

9. If symptoms do not start to improve in 5 minutes, use a second auto-injector. If symptoms improve after the first dose, but return while waiting for the ambulance, use a second auto-injector. Follow the same steps listed above.

• You are not sure how or when to use the epinephrine auto-injector.

• Epinephrine was given to your child. Your child may have a second wave of symptoms. Take the used epinephrine auto-injector to the hospital with you.

• You or your child is injected in the hand or foot with epinephrine by accident.