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How to Use an Epinephrine Auto-Injector


Medical providers can prescribe an epinephrine auto-injector for a child at risk of a severe allergic reaction (anaphylaxis). Epinephrine is a drug that stops the airway from swelling.

Epinephrine in an auto-injector is often marketed as Epi-Pen. Caregivers who are expected to use an auto-injector should be trained by a medical provider at least once a year.

Follow the instructions printed on the package. Here is a summary of the steps:

  1. Take the epinephrine auto-injector out of its package. Do not use the auto-injector if:
    • It is not prescribed for the child
    • It is discolored (yellow vs clear)
    • There are particles in it
    • It is older than the expiration date printed on the side of the box
  2. Remove the safety cap. 
  3. Hold the auto-injector in your fist. The needle comes out of one end, so be careful not to hold your hand over the end.
  4. Push the end with the needle firmly against the side of the child's thigh, about halfway between the hip and knee. Inject the medicine into the fleshy outer portion of the thigh. Do not inject into a vein or the buttocks.
  5. You can give the injection through clothes or on bare skin.
  6. Hold the auto-injector in place until all the medicine is injected—usually no more than 10 seconds. 
  7. Remove the needle by pulling the pen straight out. A protective shield will cover the needle as soon as it is removed from the thigh. Put the injector back into its safety tube. Give it to EMS when they arrive.
  8. Massage the area after the injection.​
Last Updated
Pediatric First Aid For Caregivers And Teachers (PedFACTs), 2nd Edition (Copyright © 2013 Jones & Bartlett Learning, LLC, an Ascend Learning Company, and the American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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