11.3 Epinephrine auto-injector use and precautions

Epinephrine auto-injectors are lifesaving devices for severe allergic reactions. They deliver a quick dose of epinephrine to combat anaphylaxis symptoms like breathing difficulties and low blood pressure.

Proper use is crucial. Inject into the outer thigh, hold for 3 seconds, and seek medical help. Always carry two doses, check expiration dates, and practice with training devices to stay prepared.

Epinephrine Auto-Injectors

Epinephrine Medication

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• Epinephrine is a medication used to treat severe allergic reactions (anaphylaxis)
• Acts quickly to constrict blood vessels, relax smooth muscles in the lungs to improve breathing, stimulate the heart, and reduce swelling and hives
• Available in auto-injector devices for easy administration during emergencies
• Common brand names include EpiPen, Auvi-Q, and Adrenaclick

Auto-Injector Devices

• Auto-injectors are designed for quick and easy administration of epinephrine during an anaphylactic emergency
• Consist of a spring-loaded needle that automatically injects a single dose of epinephrine when pressed firmly against the thigh
• Provide a convenient and portable way to carry and administer epinephrine
• Some auto-injectors have audio and visual instructions to guide users through the injection process (Auvi-Q)

Dosage and Availability

• Epinephrine auto-injectors are available in two dosages: 0.15 mg for children weighing 33-66 lbs (15-30 kg) and 0.3 mg for children and adults weighing over 66 lbs (30 kg)
• Prescribed by a healthcare provider and can be purchased at most pharmacies
• People with known severe allergies should carry two doses of epinephrine with them at all times in case a second dose is needed before emergency medical help arrives

Administration Technique

Injection Site and Method

• Epinephrine should be injected into the middle of the outer thigh (vastus lateralis muscle)
• Can be injected through clothing if necessary
• Remove safety cap and press auto-injector firmly against the thigh at a 90-degree angle until a click is heard, then hold in place for 3 seconds to ensure full dose is delivered
• Massage injection site for 10 seconds to promote absorption

Second Dose Administration

• If symptoms do not improve within 5-15 minutes or if symptoms return, a second dose of epinephrine may be needed
• Administer second dose in the opposite thigh
• Seek immediate medical attention after using an epinephrine auto-injector, even if symptoms seem to have resolved

Training and Practice

• Individuals with severe allergies, as well as their family members and caregivers, should be trained on how to recognize signs of anaphylaxis and properly use an epinephrine auto-injector
• Practice with a training device (often provided by the manufacturer) to become familiar with the injection technique
• Review instructions and practice regularly to maintain competency in using the auto-injector

Precautions

Storage and Expiration

• Store epinephrine auto-injectors at room temperature (68-77°F or 20-25°C) and protect from light
• Do not refrigerate or freeze, as this can cause the device to malfunction
• Check expiration dates regularly and replace expired auto-injectors
• Most epinephrine auto-injectors have a shelf life of 12-18 months

Side Effects and Considerations

• Common side effects of epinephrine include anxiety, restlessness, tremors, palpitations, and headache
• These side effects are usually mild and short-lived
• Rare but serious side effects can include irregular heartbeat, chest pain, and stroke
• Use with caution in individuals with certain medical conditions such as heart disease, high blood pressure, and diabetes
• Inform all healthcare providers of epinephrine use and presence of severe allergies