Welcome to the April edition of our Community Education series.  Since the weather is starting to become more Spring-like, we would like to share some information about Epinephrine Auto Injectors, also commonly known as Epi-Pens.

What is an Epi-Pen?

Epi-Pens are medical devices usually prescribed to people that have a known severe allergic reaction also known as anaphylaxis.  Epi-Pens carry the medication epinephrine which is a TEMPORARY relief of symptoms related to an anaphylactic reaction. It it normally administered through an injection using a needle embedded inside the device.  In this article, we will cover in depth how epinephrine works to relieve the symptoms of an anaphylactic reaction and the do’s and don’ts of epi-pen administration.

Signs and symptoms of an anaphylactic allergic reaction!

In most allergic reactions, people experience itching, sneezing, hives, and other non-life threatening symptoms. However, with anaphylaxis, that is not the case.  Anaphylactic reactions are the extreme reactions to allergens that are less common but can be deadly. Signs and symptoms can start as swelling of the face or affected body part such as a bee sting to the arm and then the arm swells.  It can then progress to having rapid breathing along with wheezing during breaths due to the airway beginning to close. As the swelling progresses, it can completely occlude the airway causing loss of consciousness. Other signs are feeling light headed and dizzy as your blood pressure drops due to the body trying to combat the allergen.  Nausea and vomiting are also common along with hives, rapid heart rate, and an itchy tongue. Not all people will experience all of the symptoms mentioned above but still will need medical attention should they come in contact or ingest what they have a known allergy to.

How does epinephrine work during an anaphylactic allergic reaction?

It constricts blood vessels to increase blood pressure, relaxes smooth muscles in the lungs to reduce wheezing and improve breathing, stimulates the heart (increases heart rate) and works to reduce hives and swelling that may occur around the face and lips.

How to administer an epi-pen

There are a few simple steps to administering or helping to administer an epi-pen.  FIrst you should make sure that the epi-pen is prescribed for the person being injected.  Next, checking the expiration date and medication color. If the medication itself looks cloudy, do not inject it as it most likely has expired.  Next is finding the best place to inject (usually the upper thigh area). Once you are ready to inject, pull the safety and stay clear of the end with the needle.  Press into the thigh area and hold in place for at least 10 seconds to ensure all of the medication has been injected. FInally, call 911 regardless if the symptoms subside or not.

Should you seek medical attention after administering an epi-pen?

Yes, it is important to be evaluated at the hospital because the relieving effects of the epinephrine are a temporary measure and symptoms can re-appear once the epinephrine wears off.  Long term treatment should be determined at the hospital due to not knowing how long the allergen may be present in your body.

Myths about epi-pens

Some of the common myths are as follows:

• “Epi-Pens cure allergic reactions” (they slow down the symptoms and can temporarily reverse them, but not “cure” them)
• “I can use any epi-pen available” (While many epi-pens may look the same, there is a reason they are prescribed and not over the counter.  There are Epi-Pen Jr.s for children along with other types of pens that can inject a different dose than others)
• “I can administer it anywhere on the body” (It is highly recommended that you administer the epi-pen as shown on the injector or by your physician.  The best place to administer is usually the upper thigh area but not your buttocks)
• “Epi-pens don’t work through clothes” (Epi-pens are designed to be able to go through some clothing including jeans and sweatpants)
• “I can wait to go to the hospital” (while epi-pens will reduce or relieve the symptoms of the reaction, it is a fast acting medication that will wear out and the reaction can flare up again if long term treatment has not started)