Epi-Pen Misuse is Killing People

Epi-pens and other epinephrine auto-injector devices are designed to be easy to use in the case of an anaphylactic reaction, but 4 out of 5 people who have one don’t use it correctly! As I’m writing this, it’s Christmas eve and the chances of someone accidentally encountering an allergen and having a reaction are high, so let’s brush up on using Epi-Pens and talk about recent research that say’s people are messing up.

Epi-Pen Adult and Epi_pen Jr.

Epi-Pen adult and Junior. “Blue to the sky, orange to the thigh!”

How to use an Epi-Pen

  1. Remove the auto-injector from the clear carrier tube or any other packaging
  2. Grasp the auto-injector in your fist with the orange tip pointing down. With your other hand, remove the blue safety release by pulling straight up without bending or twisting it.
  3. Hold the auto-injector with orange tip near the outer thigh.
  4. Hold the auto-injector with orange tip near the outer thigh.
  5. Hold firmly against the thigh for approximately 10 seconds to deliver the drug. The injection is now complete.
  6. Remove the auto-injector from the thigh. The orange tip will extend to cover the needle.
  7. Massage the injection area for 10 seconds.
  8. Get emergency medical help right away.

Get the full information sheet from the manufacturer right here.

All of these steps are covered in the majority of our training courses, along with a demonstration and the chance to see & handle training devices… and it seems easy enough, so what could go wrong?

Epi-Pen Misuse

Based on recent research in the Annals of Allergy, Asthma and Immunology…. 102 patients who use an Epi-pen were studied. 16% of them used the epi-pen correctly! Yes that’s right, 84% (more than 4 in every 5) of people with an Epi-Pen are using it incorrectly. So how can you misuse an Epi-pen if they’re meant to be so easy?

Fully three-quarters of people do not hold the injector against their thigh for long enough. Although medication delivery is rapid, the 10 second requirement is put there by the manufacturer and presumably for a good reason.

Next, well over half of people are not holding the device in the palm of their hand. It may seem minor, but if a user accidentally injects their thumb or fingers the medication won’t work to save their life… and it reduces circulation in the thumb/finger, putting them at risk of gangrene if they survive long enough.

Other common errors included failure to place the needle end of the device on the thigh and failure to depress the device forcefully enough to activate the injection. The least common error was failing to remove the cap before attempting to use the injector.

Most patients made multiple mistakes and more than half (56%) missed 3 or more steps and would not have benefited from self-administration of the potentially life-saving
treatment if the need arose.

A full list and tables showing how many people make which mistakes can be accessed via ScienceDirect.

Epi-Pen Training

If you aren’t sure how to use an Epi-pen and you need to know, find out now! Don’t leave it until the day you need it. Join one of our courses, take a course with someone else, view the videos on the manufacturer’s website. Whatever it takes – don’t just assume they’re easy to use, apparently that’s not true.

About Tony Howarth

Tony is a First Aid & CPR Instructor Trainer with Sea 2 Sky Safety Training Services and the company founder. Tony started with the British Red Cross in 1994. Has acted as first aid attendant for hundreds of events & treated many hundreds of people as a result. He is experienced in training a wide range of courses. He previously worked as an ambulance attendant with the British Red Cross. He is now in BC as a first aid instructor, and an instructor trainer (one who trains others to become instructors) Finally, Tony works at UBC Hospital as a pharmacist when not busy training safety
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2 Responses to Epi-Pen Misuse is Killing People

  1. Paul says:

    Both my wife and I have Epipens and know how to use them. We also have a four year old. He doesn’t have allergies but if anything ever happened where he had a bad reaction to something I wonder if using the adult dose would be better than using nothing if help were not coming quickly?

    • Tony Howarth says:

      Paul, we teach in class that the adult dose is fine for kids. It may leave him a little ‘hyper’ but that’s manageable and better than the alternative. (The reverse is not true. Kiddy doses may not be enough for an adult. )
      Also, use them even if slightly out if date, in a life-or-death situation.

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