When Should You Use an Epi-Pen?

Dietrich Easter

A lot of people who have epi-pens have never actually used one. This leaves people with allergies wondering: when should you use an epi-pen? And what are the symptoms of anaphylaxis that you should look for? 

You should use an epi-pen as directed by the physician who prescribed the medication. Epi-pens should be used when a person displays signs of an anaphylactic reactions. Some common symptoms of anaphylaxis include rash-like hives, upset stomach, wheezing, swelling, and known exposure to an allergen. 

Don't worry, in the next sections, we'll go over more steps to recognize an allergic reaction. Beware, failing to know when to use an epi-pen could be life-threatening! 


When to Use an Epi-Pen in an Allergic Reaction

People are often afraid of hurting someone by accidently using an epi-pen at the wrong time. While this is an understandable concern, it's imperative that epinephrine is administered. Epi-pens save lives! 

With that said, let's talk about some signs that it's time to use an epi-pen. Later on, we'll answer questions about what an allergic reaction actually is, how epinephrine works, and why more people should get trained in first aid. 

When it's time to use an epi-pen: 

  • Use an Epi-pen If you notice any trouble breathing 
  • Use an Epi-pen after exposure to a known allergen 
  • Use an Epi-pen If the person has multiple signs of an allergic reaction

  • Disclaimer: Always follow the guidance of the person's prescribing physician. Not everyone presents with the same symptoms. Ultimately, the physician will know the patient best. Also, this article is not meant to be medical advice! Medical standards are constantly changing - there's a chance information in this article could be irrelevant in a few years. Be sure to stay up on your first aid training and to contact a physician for further advice!

    Use an Epi-pen If You Notice Any Trouble Breathing 

    Trouble breathing is a serious sign when it comes to allergic reactions. Often, people with allergic reactions will just have local swelling or some minor hives. But if you notice that a patient has trouble breathing, that means the allergic reaction has likely progressed to a severe state.

    How do you know if a person with an allergic reaction is having trouble breathing? First, ask them! However, they may not be able to talk. In that case, listen for wheezing, which is a high pitched whistling sound. Also, keep an eye on any swelling to the lips, tongue, or throat. If you see any of these signs, it's probably a good idea to use to epi-pen if they have one! 

    So remember: if someone has been exposed to a known allergen, and they're having trouble breathing (wheezing), done afraid to use the epi-pen as directed by their physician. 

    Use an Epi-pen After Exposure to a Known Allergen with Signs of Shock

    Another time to consider using an epi-pen is if the person is showing signs of shock. Now, shock in the medical sense is much different than "shock" as you might know it. A lot of people use the term "shock" to mean that someone is overwhelmed by fear/grief/etc.; however, that is not what shock means in a medical sense. 



    Shock in a medical sense means that the body is beginning to shut down, and that without intervention the person may succumb to their injuries. Anaphylactic reactions cause shock by dilating the blood vessels and reducing the blood pressure. How do you recognize shock? 

    Some signs of shock include altered mental status (the person seems "out of it"), a weak and rapid pulse, and low blood pressure (if you know how to measure blood pressure). So, in some cases, even if the person isn't having trouble breathing, if there are signs of shock, then the patient's physician would want you to administer the epi-pen. 

    Now, let's go over another instance where you might consider using an epi-pen. 

    Consider Using an Epi-pen If the Person has Multiple Signs of Allergic Reaction

    Sometimes you'll come across a person who has had multiple life-threatening allergic reactions in their lifetime. For these people, you will need to act fast in order to save their life and reverse the anaphylactic reaction. 

    For people who know the early signs of a severe allergic reaction, you might consider administering the epi-pen before you notice trouble breathing or signs of shock. A rule of thumb is this: if there are two or more body systems involved in the allergic reaction, consider using the epi-pen. 

    Let's explain this. 

    So, let’s say someone was stung by a bee. They've been stung before, but they've never had an anaphylactic reaction. Their current symptoms are hives on their hands. Would you give this patient an epi-pen? The answer is probably not, as this patient is only showing a mild reaction at this time. 

    Now, let's say someone accidentally ate food that contained peanuts. This person has had life-threatening anaphylactic reactions in the past. Their current symptoms are: upset stomach, and hives on their back. Would you give them the epi-pen? The answer is, yes, you would certainly consider giving the epi-pen in line with their physician's orders, as this allergic reaction is likely to turn life-threatening. 

    Do those scenarios help you understand a little better? Hopefully. 

    In the next section, we'll talk about how an epi-pen works.  



    How Does an Epi-pen Work? 

    Epi-pens are built to be "simple." However, when you're in the heat of an emergency, even turning on a light switch is difficult. Many people have accidentally injected themselves with epinephrine while trying to administer and epi-pen, or they don't properly activate the pen to ensure the dose is administered. 

    In this section, we'll talk about several parts of an epi-pen and ensure that you know how to use one. Keep in mind, there are some great videos on how to use an epi-pen. Be sure to watch these videos several times. Also, you can buy an epi-pen trainer so you can practice without the risk of a needle. 


    Several things to know about how an epi-pen works: 

    • Epi-pens are auto-injectors: Epi-pens are auto-injectors. This means that all you have to do is push the injector in the right place, and the medication will automatically be administered. You don't need to push any plungers like a regular syringe. The medication is activated within the injector when the tip is compressed against the skin. You'll feel a "click" and you'll need to hold the injector in place for about ten seconds to fully administer the med. 
    • Epi-pens contain a needle: Epi-pens do contain a needle. The needle end of the injector is clearly marked, so be sure to read the label before you administer. Never place any finger on either end of the injector! This is a bad habit and increases the likelihood of injecting a non-patient. 
    • Epi-pens can go through clothing: Epi-pens can go through a single layer of clothing, such as pants. However, I would recommend removing the clothing if possible. You wouldn't want the needle to accidently strike an object in the pocket or to hit a metal buckle/button. However, know that epi-pens are made to go through clothing. 
    • Epi-pens contain a single dose: Epi-pens are not reusable. After you give that initial injection, you'll need to get a new epi-pen. It's often a good idea to have a spare epi-pen on hand in case you lose one or in the event that it's improperly administered. You cannot and should not try to reset an epi-pen - it won't work and it could be dangerous. 
    • Epi-pens can expire: Epi-pens do have a shelf-life and you should be well aware of the expiration dates on your epi-pens. If you can, try to replace the epi-pen up to a year before it expires. Also, it's a good idea to have several epi-pens on hand that expire at different times, this way they don't all expire at the same time! 
    • Epi-pens have adult and kids models: There are generally two types of epi-pens, those made for adults and those made for children. The main difference between these two epi-pens is the dose. For adults, the dose on an epi-pen is usually 0.3 mg. For a child, the dose for an epi-pen is usually 0.15 mg. Usually, you would use the adult model on anyone greater than 66 pounds. However, be sure to follow physician's guidelines in this area. You do not want to mix an adult and child epi-pen. 

    Alright, now for some final words. 

    Conclusion: The Most Important Times to Use an Epi-Pen 

    The most critical time to use an epi-pen is if someone has been exposed to an allergen and they are having signs of trouble breathing. For people having trouble breathing (wheezes) during an allergic reaction, epinephrine will be lifesaving. 

    Keep in mind that this article is not meant to be medical advice, and you should always follow the guidelines of the patient's physician (the one who prescribed the epi-pen). If you have a friend or a family member who has an epi-pen, take some time to talk about how you would use the device if they had an anaphylactic reaction. Remember, failure to prepare is preparing to fail! 

    Be sure to check out this guide on when to see a doctor.