By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
In April the pharmacy hosted two different sets of pharmacy students. Pharmacy students are always a lot of fun because they ask interesting questions. As pharmacists we get to show them how we practice our profession and why we do what we do. That involves a lot story telling. A cautionary tale Pat always breaks out is about Trevor and the EpiPen. Pat explains to the student how Trevor was demoing how to use an EpiPen to a patient with an EpiPen trainer or fake pen. After Trevor had finished the demonstration, he pulled the trainer away from his leg, and realized it was a real EpiPen and he had stuck a real needle with real epinephrine into his leg. At this point in the story Pat and the pharmacy student laugh and laugh. And now that all of you have finished laughing, let’s talk about how to properly use an EpiPen.
EpiPens are autoinjecting syringes designed to deliver epinepherine (adrenaline) for the emergency treatment of allergic reactions. Accidental injections with EpiPens, like mine, do happen. If you accidentally inject yourself, get someone to take you to the hospital. This is especially important if you accidentally inject your finger as the epinephrine can reduce the blood flow to that finger and the finger can be damaged.
How to Use the EpiPen
- To use the EpiPen, hold the pen the middle with it in your fist. Think “Blue to the sky, orange to the thigh”. The needle comes out the orange end. Hold than end against your thigh. The blue caps should be pointed up if you are sitting. Remove the blue safety cap with your other hand. We want you to hold the pen in the middle so you don’t accidentally poke your finger.
- Hold the orange tip near the outer thigh. Swing and jab firmly into the outer thigh so that the auto-injector is perpendicular (at a 90° angle) to the thigh. Hold the needle in the thigh and count to 10 seconds slowly. This is so the whole dose goes into the muscle (Note: most of the liquid epinephrine never leaves the auto injector and it cannot be re-used). Remove the unit and massage the area for several seconds to promote the epinephrine’s distribution.
- After administering, the needle is automatically covered by the orange tip. Note the time of injection. Go immediately to the nearest hospital, or call 911. Bring the EpiPen with you.
- If in doubt, use the EpiPen. The cause of the reaction can be investigated later.
- EpiPen can be used through light clothing. It will not work though a snowsuit, but most pants are okay.
- The effects of the EpiPen may wear off after 10-15 minutes. If you live a long way from the hospital you need one EpiPen for every 15 minutes you are away from the hospital.
- If you need an EpiPen, strongly consider getting a Medic Alert Bracelet with the type of allergy, and the words “Use EpiPen” on it.
EpiPens come in 2 strengths: the EpiPen, and the EpiPen Jr. A child moves from the EpiPen Jr. up to the full strength when he/she weighs 15-30 kg (33-66 lbs.). By school age, most children should have the full strength, not the Jr. With children it is tempting to keep the EpiPen with a parent or with a teacher. The problem is that runs the risk of the adult and the child being separated at the time of an allergic reaction. The EpiPen should be with the child at all times. Children five years of age and older are capable of carrying their own EpiPen in a fanny pack. The EpiPen should preferably not be carried in the child’s backpack or in mom’s purse, but on the child. My seven year old niece Bailey has a peanut allergy. She has carried her own EpiPen since she was four.
The epinepherine (adrenaline) in the pen is light, heat and cold sensitive. We don’t want the EpiPen to freeze because the inner working of the pen could crack and then the EpiPen won’t be able to inject when need. So keep the EpiPen under a jacket in the winter. The heat of summer will actually degrade the epinephrine. So never leave your EpiPen in a hot car. Keep your EpiPen cool in the summer. The EpiPen has a window in it. Periodically check to make sure the epinephrine is clear. If it has anything floating in it or changes color at all, replace the EpiPen. EpiPens are usually good for about a year. Have your pharmacist show you the expiry date on the EpiPen, and record the expiry date in a place you will look often so you can see when it needs to be replaced.
EpiPens are expensive. They are over $100 each. Parents and patients are understandably concerned by the price. But in my opinion, they are worth the price. So buy the EpiPen if your doctor says you need one. Replace the EpiPen every year when they expire. Although they are expensive, they can save a life.
One of the best parts about being a pharmacist is I learn something new everyday. I think I learn as much from the pharmacy students that visit as they learn from us. Learning from experience is a great teacher, but I encourage our students to read and talk to people too. For example, unlike me, they shouldn’t have to learn from experience that an EpiPen injection really doesn’t hurt.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
EpiPen site - www.epipen.ca