Information about the use of Epinephrine
Epinephrine may be supplied as an
b) EpiPen Jr.®
d) TwinJect Jr.
Expiration dates need to be checked regularly. Auto-injectors should be stored at 25*C (77*F). (On a field trips the permitted range is 15* to 30*C ( 59*F to 86*F))
A Junior EpiPen® with .15 mg of epinephrine, should be provided if the student weighs 15 - 30 kg (33 - 66 lbs), to ensure the proper dosage is administered. The student’s weight is be recorded on the Emergency Medical Alert Form. (AP-314-F-D3) An adult EpiPen with .3 mg of epinephrine should be provided if the student weighs 30 kg (66 lbs) or more.
The following is a synopsis of the training that would be provided to staff in First Aid Certification. This section is not meant to replace the training sessions.
When injecting an auto-injector, ensure the proper end is placed on the thigh. Many incidents were reported where thumbs were accidentally injected rather than the anaphylactic individual. Arrows pointing toward the tip of the auto-injector have been added right next to the instructions that read, “Place tip against outer thigh. This will assist new users in properly administering the auto-injector.
When injecting, remember to hold the auto-injector against the body for a full ten seconds, to allow complete dissemination of the medication. The anaphylactic student's leg may have to be held firmly to avoid disengaging him/her from the auto-injector. It is normal to see some liquid left in the used auto-injector. The statement “1.7 ml. of liquid will remain after activation” was added to avoid confusion. The complete dose of epinephrine will have been injected if it was held in place for ten seconds. Massage the area for 10 seconds after injection.
It is not uncommon for individuals to be fearful of using the auto-injector the first time, if up until then they have only practised with the trainer. There is confusion from first time auto-injector users about not hearing the “click” on the real auto-injector, as one hears when using the trainer.
The actual auto-injector does not have a “click” but one can feel the device activate. On Epi-Pens an orange sheath surrounds an exposed needle. On TwinJects, the exposed needle will need to be bent backwards on a hard surface if the second dose is needed.
It is recommended that the used auto-injector be disposed of at your local Health Unit, at your own pharmacy, or at the Hazardous Waste Depot, rather than a trash container at home or school. It may be helpful to take it to the Hospital Emergency Room to show what was given.
ALL individuals receiving emergency epinephrine must be transported to hospital immediately. Further treatments may be required and therefore observation in a hospital setting is necessary.
Additional epinephrine must be available during transport and may be administered after 10 to 15 minutes, should symptoms not subside or in fact, reoccur.