How to Use an EpiPen: Instructions, Emergency Tips, and More

The video below walks you through how to administer an EpiPen to yourself.

In summary, follow the steps below to administer an EpiPen to yourself:

1. Carefully remove the EpiPen from its clear carrier tube.
2. Grip the barrel of the EpiPen in your dominant hand so the orange tip points downward. Make sure your fingers aren't close to either end of the EpiPen.
3. Use your other hand to pull straight up on and remove the blue safety release. Don't twist or bend it.
4. Firmly place the orange tip of the EpiPen against the middle part of your upper thigh, pushing until it makes a clicking noise. This lets you know that the epinephrine injection is underway.
5. Hold the EpiPen in place for at least 3 seconds, counting off slowly, before removing it from your thigh.
6. Use your fingers to gently massage the area of the injection for about 10 seconds.
7. Call 911 to seek emergency care, or tell someone close to you to call.

An EpiPen can be administered through clothes if necessary.

If you need to administer an EpiPen to another adult, follow the steps above and administer the injection into the upper thigh. It may help to administer the EpiPen while the person is laying down or sitting.

The video below will instruct you on how to administer an EpiPen to a child.

Follow the steps below to administer an EpiPen to a child:

1. Remove the EpiPen from its clear carrier tube.
2. Form a fist, gripping the EpiPen in your dominant hand so the orange tip points downward. Make sure your fingers aren't covering either end.
3. Use your other hand to pull off the blue safety release. Pull it straight off. Don't twist or bend it.
4. Position the child to receive the injection. Older children can sit or lie down. Smaller children may need to be held in your lap. Be sure to hold their leg gently yet firmly in place.
5. Place the orange tip of the EpiPen firmly against the middle part of the child's upper thigh. Push until it clicks.
6. Be sure to hold the EpiPen in place for a least 3 seconds before you remove it from the child's thigh.
7. Carefully massage the injection area for about 10 seconds.
8. Call 911 to seek emergency care.

The symptoms of anaphylaxis come on quickly and can rapidly worsen. Anaphylaxis is an emergency situation. If you or someone else is experiencing symptoms, don't hesitate to administer an EpiPen and seek emergency care.

Symptoms to look out for include:

• difficulty breathing
• swelling of the throat, face, or lips
• wheezing or a hoarse voice
• feeling dizzy or lightheaded
• rapid heartbeat
• hives and itching
• pale or clammy skin
• nausea or vomiting
• diarrhea
• abdominal pain
• low blood pressure
• a feeling of doom
• fainting or collapsing

Antihistamine medications, such as Benadryl or Claritin, can be used to either prevent or ease allergy symptoms.

It's appropriate to use these medications to relieve mild allergy symptoms such as sneezing, itchy or watery eyes, and hives.

However, never use antihistamines alone to treat anaphylaxis. Not only do they not act as quickly as epinephrine, but they also can't effectively prevent or reduce some of the more serious effects of anaphylaxis, such as airway obstruction and low blood pressure.

If you or someone else is experiencing anaphylaxis, epinephrine should be administered immediately. You should then get emergency medical attention.

What should you do in the event that someone is experiencing anaphylaxis? Follow the steps below in an emergency situation.

1. Call 911 immediately.
2. Ask the person if they're carrying an EpiPen on them. If so, ask them if they need your help administering the injection.
3. Loosen any tight-fitting clothing.
4. Help the person lay on their back. If they're feeling nauseous or have vomited, gently turn them on their side.
5. Remove any allergy triggers if possible.
6. Cover the person with a blanket if available.
7. Avoid giving them any food or drink.
8. If a second EpiPen is available, give another injection if symptoms haven't improved in about five minutes. However, more than two injections shouldn't be given without the supervision of a medical professional.
9. If there are no signs of breathing, administer CPR.
10. Stay with the person and continue to reassure them until help arrives.

Be sure to follow the safety tips below to help prevent an anaphylactic reaction or be prepared in case you experience one:

• Identify and avoid your allergy triggers. Examples of common allergy triggers include:
  • medications
  • insect bites or stings
  • foods, such as peanuts and shellfish

• Always carry your EpiPen with you. Try to carry the double pack just in case you have a reaction and one dose doesn't alleviate your symptoms, or your symptoms come back before help arrives.

• Check your EpiPen regularly. Note the expiration date as well as the color of the liquid in the injector, which should be clear. Replace your EpiPen if it's close to its expiration date or the liquid is discolored.

• Always store your EpiPen at room temperature. Extremes in temperature may make the medication less effective.

• Know the signs of an anaphylactic reaction so you can promptly administer your EpiPen.

• Know how to administer an EpiPen. Be sure your family, friends, and caregivers know as well. Many manufacturers include a practice injector so you can practice administering an injection.

• Let others know about your allergyso they know what to do in case you have a reaction. Consider wearing a medical ID that lets people know about your allergy.

• Always seek emergency medical treatment if you experience anaphylaxis. Don't just wait for your symptoms to improve.

It's very important to go to the ER for anaphylaxis, even if you've used an EpiPen. This is because the symptoms can potentially come back. People who've experienced anaphylaxis should be monitored in a hospital for several hours.

Anaphylaxis is a serious allergic reaction and is an emergency medical situation. Using an EpiPen to administer epinephrine can reverse the symptoms of anaphylaxis and stabilize your condition until help arrives.

If you have an allergy, it's important that you carry an EpiPen at all times in case of a reaction. The injection is quick and is given in the upper part of your thigh.

Both you and those close to you should also be able to identify the symptoms of anaphylaxis and know how to properly administer an EpiPen. Recognizing anaphylaxis and promptly giving an EpiPen injection can save lives.

Anaphylaxis. (2016). https://www.nhs.uk/conditions/anaphylaxis/

Anaphylaxis. (2018). https://acaai.org/allergies/anaphylaxis

Epinephrine auto-injector. (2018). https://acaai.org/allergies/allergy-treatment/epinephrine-auto-injector

Fineman SM. (2014). Optimal treatment of anaphylaxis: Antihistamines versus epinephrine. DOI: 10.3810/pgm.2014.07.2785

How to use an EpiPen. (n.d.). https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/resources-for-parents-and-kids/how-to-use-an-epipen

How to use an EpiPen (epinephrine injector, USP) auto-injector. (n.d.). https://www.med.unc.edu/pediatrics/files/2018/05/How_to_Use_EpiPen_Autoinjector.pdf

Know the difference: Epinephrine vs. antihistamines. (2014). https://www.foodallergy.org/about-fare/blog/know-the-difference-epinephrine-vs-antihistamines

Mayo Clinic Staff. (2018). First aid: Anaphylaxis. https://www.mayoclinic.org/first-aid/first-aid-anaphylaxis/basics/art-20056608

NationwideChildrens. (2011). How to use an EpiPen [Video file]. https://www.youtube.com/watch?v=EN83hen4D-Y

ParkviewHealth. (2017). How to use an EpiPen in 90 seconds [Video file]. https://www.youtube.com/watch?v=K7QyCMNDHAs