Epi-Pen Intern Training

What is an Epi-pen? Its a high dosage of epinephrine used to treat severe

allergic reaction.
Anaphylaxis is the most severe allergic reaction and it is life threatening and
therefore a medical emergency. Other mild allergic reactions can manifest by:
runny eyes, irritated skin, runny nose, throat itching, lips/tongue tingling. Theres
no need to use an Epi-pen if breathing is not severely compromised.
How can I know if someone is having a severe allergic reaction?
1. Exposure to triggers such as: insect stings, food (peanuts, fish, milk),
medicine (penicillin), latex, exercise.
2. Difficulty breathing: this will be very evident, wheezing and gasping for air
vs. just saying that they have trouble breathing.
3. Swollen tongue and lips.
4. Skin reactions: flushed and clammy skin.
What should I do? If administered on time, an Epi-pen can be the difference
between life and death. Some people dont know they are allergic to bee stings
until they get stung. Always take a little time to think if its likely that they are
having an allergic reaction or not. For example, if a resident calls in the middle of
the night saying that she has trouble breathing, its very unlikely that she is having
an allergic reaction, because she hasnt been exposed to any triggers in the last
hour.
People having a severe allergic reaction die because their airway becomes so
swollen that it doesnt allow air to flow through it. Epinephrine will open up the
airway and prevent death.
When should I administer the Epi-pen? If a resident has #1 and at least 2 of
the other 4 criteria mentioned above, it is very likely that she is having a severe
allergic reaction. If breathing is severely impaireddont hesitate, its time to
administer the Epi-pen.
How do I do it? Breathe deeply. Take the Epi-pen and remove the blue cap.
Breathe again.
Press the orange tip firmly against the residents thigh, (the needle is designed to
pierce through clothing). Hold for 10 seconds. Release.
Thats it! You know how to use an Epi-pen now. Familiarize with the Training Epipen and try it on yourself (it has no needle).
* If the resident has her own Epi-pen, they should know how to use it. So, if they
are able to do it, let them do it by themselves.

What should you do next? Wait for at least 2 minutes, their breathing and other
symptoms should significantly improve. If they dont, take them to the ER. If they
improve completely, ask the resident if she still wants to go to the hospital, though
theres no real need to go, the emergency is over.
* Residents might say that their heart is racing after the Epi-pen shot, this is a
normal side effect of epinephrine. It should go away in approximately 10 minutes.