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Top 10 Mistakes When Using an Epi-Pen® Injector
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This list contains common mistakes that people make when using an epinephrine self injector.

Tips for Practicing With Expired Auto Injectors
  • Use a firm piece of fruit like an orange or a lemon. Make sure you put it in something like a plastic container - otherwise it's likely to squirt all over. MAKE SURE YOU DO NOT HOLD THE FRUIT WITH YOUR HAND.
  • Put a stack of newspaper under your container so the needle does not go through and hit your counter. It's a long needle! See #6 above for disposal tips.
  • Practice with your Epi trainer. If you have a child with a food allergy, have them practice with it as well.
  • To help a child become comfortable with the concept, consider training his/her friends or placing the trainer in a pretend doctor's kit.

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1) Injecting the needle through your thumb. You remove the cap from one end - the needle comes out the other end. Not removing the cap is another typical mistake - the pen won't inject if the cap is on.
2) Injecting into the seam of blue jeans. Epi will go through pants, but it will not go through seams easily.
3) Injecting into the wrong part of the leg. It should go in the fleshiest part (usually on the side). You will NOT hit bone. My son is the skinniest kid in existence - we have never hit the bone.
4) Injecting into the hand not holding the needle. Don't put your hand on the leg! Instead, grasp the cylinder in the middle with your fist and jab. (This also prevents you from putting the needle through your thumb if you get the wrong side and lets you hold more firmly if the kid jerks.)
5) Pulling the needle out in surprise when it injects. Remember that you have to hold the needle in place for 10 seconds. Keep in mind your child may be flailing at this point (and certainly crying). If your child is younger, have another adult be prepared to hold him/her down. According to my son it really doesn't hurt that much, but younger children are likely to go over the top with the whole thing.
6) Poking yourself with the (long) needle when you do take it out. Be very careful with this! It should go back in the plastic case you took it out of. Take it to the ER with you, both because they will want to make sure it injected fully and because they can discard it in a sharps container.
7) Using discolored solution. The medication should be clear. If it's not, don't use it (unless you have no other epi).
8) Needle doesn't inject. There is a misfire in some cases with Epis. That's why you keep at least two around, right? If you don't see a needle, you have a problem.
9) No back-up shot in case symptoms return. They can come back, usually about 20 minutes after the initial shot (and more common in older kids or adults where the epi dose wasn't proportional to body weight). Keep another epi around.
10) Confusing panic with the symptoms returning. This is the scary one - a few people have died from epinephrine overdose because they kept injecting themselves. Talk to your doctor about dosing in general and be cautious about giving Epis closer than 20 minutes apart.
List compiled by booandbrimom
For more information or specific step-by-step instructions, visit Dey's Epi-Pen® site.

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