What You Should Know About Using an Epinephrine Auto-Injector (Like EpiPen®)

Whether you have allergies or know someone who does, you’re far from alone. According to the Asthma and Allergy Foundation of America, more than 50 million Americans experience one type of allergy or another each year. Meanwhile, one in 50 Americans have experienced anaphylaxis, an extreme and in some cases life-threatening allergic reaction that can be caused by any number of things. Common causes of anaphylaxis include insect and food allergies (who among us doesn’t know someone who can’t eat peanuts?) and exposure to certain animals or plants.

In many cases, an epinephrine auto-injector (such as an EpiPen®) is the only effective solution for people who go through anaphylaxis, though if you’ve never used one before, the idea of giving yourself an injection can feel a little daunting. Especially under the circumstances in which you need to use it. After all, administering medicine with a needle in an emergency situation is something doctors and nurses do, right?

Fortunately, using an epinephrine auto-injector is a super simple process—one that we’re going to take you through a little later.

First, let’s start with the basics.

What, exactly, is an EpiPen®?

EpiPen® is the brand name for a type of epinephrine auto-injector, or a device that helps you administer the drug epinephrine—a medication used to treat anaphylaxis—to yourself or others. So while you’ll hear people talk primarily about EpiPen®, they’re not necessarily referring to the branded auto-injector. This is important to know because auto-injectors each work a little differently.

Who needs to carry an epinephrine auto-injector?

Having one of these handy is a good idea for anyone who has a history of anaphylaxis. If you think you might be a good candidate for a prescription, schedule an appointment with an allergist.

You should also see an allergist if you suspect you have an allergy that can result in anaphylaxis, especially since allergies can evolve and become worse over time.

How do I know when it’s time to use one?

Once you’re at the allergist’s office, they’ll go through your medical history with you, perform a physical exam, and determine whether you should get additional testing. This might include skin tests as well as blood tests.

Then they’ll work out an allergy action plan (which could look like this) with you, which will guide when and how you use your epinephrine auto-injector.

How do I use an EpiPen® or other epinephrine auto-injector?

Now that you’ve been prescribed epinephrine, you’re probably wondering how to use it. Generally, epinephrine auto-injectors are easy to use, but can be dangerous if used improperly. Since this isn’t something you want to get wrong, we're going to have to recommend that you ask your doctor to demonstrate the correct technique for your device using a training injector.

Picnic Medical Director and expert allergist Dr. Amina Abdeldaim explains, “Sometimes physicians prescribe a brand name auto-injector, but then the patient's insurance covers the generic. That’s why most doctors will have the patient bring in their device and then demonstrate how to use it in person.”

Don’t be shy about taking a video if you think watching it a few times will help you get the hang of it!

Why is an epinephrine auto-injector used on the outer thigh?

No matter which auto-injector you're prescribed, it's likely that your doctor will tell you to aim for the muscle on your outer thigh when you inject. Why? Speed is crucial to treating a severe allergic reaction, and because of the thigh muscle’s size and high blood supply, the body is able to absorb the medication much more quickly than if you were injecting into, say, your upper arm.

What should I do after using an epinephrine auto-injector on myself?

There are a few things you need to keep in mind after injecting yourself:

1. Call for emergency medical attention (911 in most places, although your region may have a different emergency phone line) once you’ve administered the shot. You might also need a second shot if the epinephrine wears off and the symptoms of anaphylaxis return—or don’t go away in the first place—and EMS don’t arrive quickly enough.
2. Stay put. Even if you don’t end up needing a second injection, your body has just been through a lot—don’t try getting up and moving around or leaving to go somewhere else before EMS arrive.
3. Take note of what time you used the epinephrine auto-injector so you can tell EMS.

Remember that even if the tightness in your throat is waning, you might experience side effects from the epinephrine, including anxiousness, dizziness, headache, rapid heartbeat, and shakiness.

What should I do if I gave the injection to someone else?

If you’ve just given someone else an injection, here’s what to do:

1. Call EMS and tell them someone’s just had an epinephrine auto-injector injection and needs medical attention.
2. Keep an eye on the person you’ve just injected. This means making sure they stay where they are, monitoring any side effects they’re experiencing, and watching out for the return of symptoms of anaphylaxis. As mentioned above, they may need a second shot.
3. Take note of what time you administered the shot so you can tell EMS.

Things to remember

While we know that even just reading about this can seem a little scary, being prepared is more than worth it. Remember: Knowing how to use an epinephrine auto-injector correctly could mean knowing how to save a life—whether it’s your own or someone else’s.