Adrenaline Injectors for Anaphylaxis Factsheet
Introduction
Adrenaline injectors are emergency devices used to treat a severe allergic reaction called anaphylaxis. Anaphylaxis is a medical emergency and can be life-threatening.
Adrenaline injectors are used to inject a dose of adrenaline into a child's leg muscle when they are showing signs of anaphylaxis.
Adrenaline is a hormone that helps reverse the symptoms of anaphylaxis very quickly by:
- opening the airways
- raising blood pressure
- reducing swelling.
There are two types of adrenaline injectors used in Australia:
Your child’s doctor will prescribe an adrenaline injector if they are at risk of anaphylaxis. The type of adrenaline injector and the dose used will depend on your child’s weight and age.
Signs and symptoms of Anaphylaxis
Signs of anaphylaxis include:
- wheezing, difficult, or noisy breathing
- swelling of the tongue
- swelling or tightness in the throat
- a persistent cough
- difficulty talking or a hoarse voice
- dizziness
- becoming pale and floppy - in young children
- collapsing.
If your child is showing signs of anaphylaxis, you should:
- follow your child’s ASCIA action plan for anaphylaxis if you have one
- use an adrenaline injector, if there is one available
- call Triple Zero (000) for an ambulance.
 About the device
The EpiPen® is a thick tube with a blue top and orange bottom. It comes in a bright yellow box with instructions and images printed on the label.
Children are more at risk of anaphylaxis if they have:
- family members who have had anaphylaxis
- asthma
- eczema, also known as atopic dermatitis
- other medical conditions like heart disease and breathing issues.
Children diagnosed with, or at high risk of an anaphylactic allergy will be prescribed an EpiPen® by their doctor. Families will work with the doctor to develop an allergy action plan and learn how to use the device.
Using the device
Your child’s doctor will develop an action plan with you to use in an emergency.
Give the EpiPen® as your child has contact with their allergen or there are any signs of anaphylaxis.
Signs of anaphylaxis include:
- difficulty breathing
- wheezing
- swelling of the tongue and airways
- difficulty talking
- losing consciousness or passing out.
Do not wait for symptoms to show up. It is always safer to use the EpiPen® even if you are unsure.
The steps to using the EpiPen® are:
- remove the EpiPen® from the container, form a fist around the EpiPen® and pull off the blue safety release cap from the top
- have yourself or another adult hold your child in place
- place the orange end of the EpiPen® against the middle of the outer thigh
(note: the EpiPen® can go through 1 layer of clothing, but not pockets or seams) - push hard on the top of the EpiPen® until you hear a click
- hold in place for 3 seconds.
The orange end of the EpiPen® will look longer after it has been used because it is covering the needle.
After using the EpiPen®, put it safely to the side and call Triple Zero (000) for an ambulance.
Tips for safely using an EpiPen® include:
- use the rhyme “blue to the sky, orange to the thigh� to help place the pen
- do not touch the orange tip of the EpiPen® with your fingers, thumb, or hand - this is where the needle is located.
- do not “swing and jab� or “stab� the EpiPen® as this can cause the needle to come out before it hits your child’s thigh
- do not try to remove your child’s clothing - the EpiPen® can go through 1 layer of clothing, but not pockets or seams.
Using an Anapen
Using an EpiPen®
 After using the device
After using the device, you will need to:
- call Triple Zero (000) for an ambulance, even if your child looks better
- check your child for symptoms while waiting for the ambulance
- use a second device if your child is not improving after five minutes, if one is available.
When the ambulance arrives, give the used injector to the paramedics.
Your child will be taken to the nearest hospital to be checked by a doctor. They will need to stay in the hospital for at least 4 hours to make sure:
- they are fully recovered
- they are not at risk of anaphylaxis returning.
Ask the doctor at the hospital to replace the used injector or provide a prescription for a new device before going home from the hospital.
 Care of the device
Prescription
Your child’s first adrenaline injector must be given by a specialist doctor, like a:
- paediatrician
- allergist
- emergency specialist.
Your local doctor can write a replacement prescription after the first adrenaline injector has expired or been used.
Cost
In Australia, children and adults who need an adrenaline injector can get up to two devices for a lower cost under the Pharmaceutical Benefits Scheme (PBS).
Extra adrenaline injectors can be purchased at full price without a prescription from your local pharmacy.
Storage
Store your child’s device in a cool place at room temperature. Do not refrigerate it.
Keep the injector readily available if your child needs it.
For younger children:
- give one device to daycare or preschool
- keep the second device with a parent or carer.
For older children and teenagers:
- give one device to their primary or high school
- keep the second device somewhere your child can reach it at all times outside school hours
- high school students should also carry a device in their school bag.
Never store an injector in a place that cannot be accessed quickly, like a school locker.
Expiry
An adrenaline injector will expire 12-24 months from the date it is made. The expiry date is printed clearly on the box and the device.
Replace expired devices as soon as possible.
You can still use an expired device in an emergency. Using an expired adrenaline injector in an emergency is better than no device at all.
Make sure your child’s device is in-date by:
- writing or saving a reminder in your phone or calendar before the expiry date
- joining a service like EpiClub to receive email or text reminders two months before the expiry date.
Ìý²Ñ²¹²Ô²¹²µ±ð³¾±ð²Ô³Ù
Side effects
Adrenaline can cause:
- shaking
- a feeling of anxiety
- fast or fluttering heartbeats
- headache
- nausea.
Your child may also look more pale than usual. These are normal side effects and should go away once the adrenaline wears off. This may take 15 to 20 minutes.
ASCIA Action Plan for Anaphylaxis
Your child’s doctor will develop an ASCIA Action plan to share with anyone who cares for your child, including:
- parents and carers
- childcare centres
- schools.
ASCIA Action plans are used to manage allergies and allergic reactions safely.
Your child’s plan should be updated regularly, and a copy should always be kept
- with your child’s devices
- on the mobile phones of parents and carers for easy access
- with the school or daycare and any other services your child attends.
Trainer Devices
A trainer device helps parents, carers, and children practice using the injector. Trainer devices don’t contain a needle or adrenaline and are safe to use. They can be purchased at your local pharmacy.
Anaphylaxis and Other Medications
Adrenaline is the only effective treatment for anaphylaxis.
Do not use other medications, including antihistamines or asthma puffers, to treat anaphylaxis.
Resources and more information
title
The Australian Society of Clinical Immunology and Allergy (ASCIA)
title
Allergy & Anaphylaxis Australia
title
AllergyPal
