Using Epipen JR. Tips Please

Posted on: Tue, 07/16/2002 - 2:59am
yuckypeanutdad's picture
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pHas anyone around here had to use one on a toddler....? I have never used one on my 2YO son yet (thankfully), and I was wondering how you experience was... The instructions are ok, but leave alot of questions in my mind.... Is the injection pretty much administered in the first few seconds after you jab...? Im worried, that if I jab my son with the pen and try to hold him as still as posible, what if he jumps away and the needle comes out before the medication has finished entering him. What are your experiences, and any tips are appreciated... Hopefully I will never have to use it, but it's great to know./p

Posted on: Tue, 07/16/2002 - 5:56am
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I haven't used the EpiPen yet, but an acquaintance of mine described using it on her then-3 year old.
She said it has a surprising "kick back" or "recoil" and that the needle may pop back out if you're not holding the EpiPen firmly against the skin. She highly recommends trying out a real, expired EpiPen on a piece of fruit, like an orange, because the EpiPen trainers do not have the same recoil as the real thing.
She held it in for ten seconds, then rushed him straight to a hospital. That's the important part! Always call 911, or head straight for the hospital if it's very close by (driving carefully!) after administering the pen. If you think you're too shaken up to drive, don't risk it - call an ambulance. I have read stories where parents have nearly become involved in auto accidents in the frantic rush to the hospital.
I've also heard it's now recommended to massage the site of injection for a few seconds after you withdraw the needle, to help disperse the medication more efficiently, but this is not strictly necessary.
She said the needle is surprisingly long, so I don't think it would just "pop out" of the skin, as long as you are holding him and the EpiPen firmly. Make sure he is laying down before you inject - that way he can't squirm away.
Welcome to the site! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
Carolyn

Posted on: Tue, 07/16/2002 - 6:12am
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[url="http://www.allergic-reactions.com/consumer/5_2.cfm?continue=1"]http://www.allergic-reactions.com/consumer/5_2.cfm?continue=1[/url]
Someone posted this link elsewhere on this site...I found it helpful!
Good luck, and here's to never having to use our epi-pens!
Beth

Posted on: Tue, 07/16/2002 - 8:04am
Anonymous's picture
Anonymous (not verified)

We had to use the EpiPen Jr on our 3 yo and when my husband injected the pen, he immediately pulled it out before the 10 seconds were up. Thank God he got enough medication in him to keep his throat from closing up but if you have to inject the pen, it is important to keep it in long enough so they do get enough medication into their system. We got lucky!
Cayley's mom made an excellent point...call 911 and let them transport to the hospital. By going via Rescue, they can monitor your child and keep in constant contact with the ER doctors and you get admitted *immediately* into an ER room--you bypass the waiting room altogether.
Here's hoping you never have to use one. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
------------------
Stay Safe.

Posted on: Tue, 07/16/2002 - 9:57am
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Thanks!... You guys are awesome..! We have spent lots of time discussing "The emergency plan"... We will be jabbing him and then immediately calling an ambulance, regardless of the seriousness attack.. An $50 ambulance bill for a trip to the ER even if he ends up being ok is alot better than taking a gamble with his life.... At least thats the way we look at it... Keep the tips coming... Not only for us, but for any other new PA parents... Those Epipen instructions that come with the units are far from detailed....

Posted on: Tue, 07/16/2002 - 10:31am
Anonymous's picture
Anonymous (not verified)

Also, if you haven't seen it yet, check out the *Links* board and Gail W. has posted an excellent link to Dey (makers of the EpiPen) for showing exactly how to use the EpiPen via a Slide Show.
------------------
Stay Safe.

Posted on: Tue, 07/16/2002 - 2:29pm
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I used it on my daughter when she was 2 years 7 months. Of course, I wasn`t planning on doing it, but I had watched the FAAN video "It Only Takes One Bite" about every six months before that, and it was really easy to do. The real one is easier than the trainer, because the click is very loud. The instructions are right on it, and also on the trainer. I read the instructions out loud to help myself concentrate. I explained to my daughter that I had to give her a shot and she had to hold still, and she did. If you are worried about your child moving, probably what I would do is put one of your legs over his two thighs (assuming you don`t have someone to hold him). Assuming you are right handed, you would put your left leg over his upper thighs, so that the spot where you will inject the Epi is to the right of your left leg. Then you could use your left hand to hold the part of his right thigh where you are going to inject, and then inject with your right hand. You are sitting to your child`s right. I know that it is really hard to visualize what I am saying---just practice the position. You definitely don`t need to massage the leg, by the time the needle is out the epinephrine is already working. It is that fast. I think if you were alone and you couldn`t get your child to lie down, it would be okay. It would be better to use your hands and legs to steady his thigh. If you watch the FAAN video and practice frequently with the trainer, I really don`t think you will forget to leave it in for ten seconds, because if you read the Epipen, the instructions are on it. If you ever have to do it, just read it. It has three steps and one of them says to leave it in for a few seconds. If you read that, you will remember not to take it out right away. If you have your left leg over your child`s upper thighs, he won`t be able to wiggle enough to make the Epi come out of his leg prematurely. And if you explain to him that he is really sick and you have to give him a shot, he may hold still anyhow. I think my daughter saw how upset I was and knew she`d better hold still or else! About the ambulance, our allergist was fifteen minutes away by car, and the ER was five minutes away, but I knew I would see a stranger who might or might not know a lot about food allergies. So I decided to put another Epi in my purse and head for the allergist. I had a neighbor sit in the back with my daughter (in her car seat). I undressed my daughter and put a blanket over her (it was December) and about every two minutes I told the neighbor to take the blanket off and see if the rash was coming back. I`m not sure I would recommend doing what I did, because the first minute or two I was very shaken and did not drive well. After a couple of minutes, when the neighbor said the rash was still gone and my daughter was fine, I was able to drive okay. Although they say the Epi only lasts 15 to 20 minutes, it lasted much longer for us, at least an hour. The doctor gave her an antihistamine, I can`t remember which one, and a steroid. He said give the steroid if the rash comes back and if the rash comes back keep giving the antihistamine. The rash came back after we left the allergist`s office. When the rash came back, it looked really different---it didn`t look like hives. It looked sort of mottled. By the way, the Epi worked in less than a minute. It was shocking (in a good way) how fast it worked. I gave it, went to put it on a high shelf, and when I looked at my daughter she was COMPLETELY FINE!!! It was like nothing had ever happened! You are actually supposed to take the Epi to the ER with you so that they can see what you gave, but I just told them I gave Epipen Jr, and there is only one dose for that so they knew what it was. I also wrote down the time I gave it, so I would know when it might wear off.
I guess my advice would be practice with the trainer and watch the video "It Only Takes One Bite" until you feel comfortable and then at least once every six months after that. Hopefully you will never have to use it, but believe me if the moment comes you will be glad you practiced.

Posted on: Tue, 07/16/2002 - 5:53pm
Noslo's picture
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Carefulmom,
What a wonderful source of information you have just given us. I haven't had to use the Epipen (we have a 4 1/2 yr old little boy w/ PA),but thanks to you and as you say, " IT ONLY TAKES ONE BITE", I would feel okay doing it on my own. Scared, shaken...but I'd do it. I am never up at this time, but something got my son yesterday and I am getting up to check his breathing. It gives me great peace of mind when I come to this place for alittle help and get an overwhelming source of information like yours. Many thanks and God Bless you for being such a great and caring and very smart Mom!

Posted on: Tue, 07/16/2002 - 9:42pm
yuckypeanutdad's picture
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Thanks Carefulmom, that was greatly detailed... Exactly what im looking for.... Where do you get the trainer pens?... From the doctor, or pharmacy?... I wouldn't mind picking one up to practice....

Posted on: Tue, 07/16/2002 - 10:08pm
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My then 18 month old son was at day care and ate a cookie of unknown origin that he swiped from another child who was being dropped off. He was broken out with eczema and they were unsure if he was having a reaction or if it was just eczema and decided to err on the side of caution (as stated in our emergency plan!) and give him the epi. The nurse at day care had never actually had to give a child an epi-pen before and Ben seemed okay other then very red in the face. Well, he decided that he did not like the looks of the epi and moved at the last second and she ended up sticking herself in the hand. While all this was going on the director was calling the doc and dad. Dad was minutes away and got there just after they successfully used the second epi. To use the second one they put Ben on the floor instead of holding him. Dad and Ben went to the doctor (whose office is in the same building as the hospital) while the director tracked down the parent of the kid who had brought in the illegal cookie. The cookie turned out to be peanut free, the red face was just ezcema and possibly anger over losing the cookie. I was glad to see that they did not hesitate to use the epi and follow the emergency plan even though it turned out to be a complete over reaction. Since our insurance does not pay for epi pens they did reimburse us for the pen the nurse injected into her own hand. BTW, she was fine other then very embarassed. She did say it was interesting to learn that it was not painful. I learned that if I had to give him the epipen I would make sure he was secure first.
Ann

Posted on: Wed, 07/17/2002 - 2:55am
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Well, I guess I forgot to say put the child on the floor because I thought it was obvious. I don`t see how you can hold a child still if he is on your lap because you would not be able to use your legs to hold him, because he is sitting on your legs. If you put him on the floor, he already can`t move in one direction because the floor is under him. About the day care, there was no other adult?? Weren`t there two people?? So why didn`t one hold and one inject?? To me that is common sense. It makes me wonder if the "nurse" is really a nurse. Oh well.
One more comment about my experience and the take home lesson. Both of my daughter`s reactions, the one I mentioned from December 1997 and the WholeSoy incident last April, at the time of the reaction there was no known exposure. Both times I later found out what caused it, but at the time of the reaction she had not eaten anything known to be unsafe. So if it looks like your child is having a reaction, but you are sure he has eaten only safe food, assume that it really is a reaction anyhow and treat it. You can figure out later what caused it, and if it wasn`t a reaction you haven`t done any harm by using the Epi. With the WholeSoy incident, my daughter had been eating it for 3 months without a problem. So don`t assume just because your child is eating something he has eaten 100 times that this can`t be a reaction. With the WholeSoy incident it turned out their product was made on shared equipment with peanuts and not stated. Her allergist later said that probably a fraction of a peanut got lodged in the equipment. Then it was released many batches later in a different flavor. That would explain why she had eaten in so many times without a problem. The company is not required to list that it is a may contain, although many do state it. I have seen on these boards that ice cream is often a may contain and not stated.
The first reaction, the one I described earlier, it was a reaction to the first time she had egg. This was just three days after she was skin tested for egg and it was negative, so I believed she was not allergic to egg. Also, every reaction can look different, even in the same child. So if previously your child turned purple and threw up, and he has different symptoms in the future but they are symptoms of a reaction, don`t think to yourself that it can`t be a reaction because last time he vomited and this time he didn`t.
Also, I forgot to mention that when you go to the ER, it is recommended that you stay until 4 hours after the exposure because the reaction can be biphasic. I didn`t know this when my daughter had her egg reaction, and we got to the allergist`s office about half an hour before closing. She looked fine and they let us go home. I checked my records and they gave her the antihistamine Claritin in the office, and a prescription for Pediapred (steroid) to take home if the rash came back which it did. If it happened again, I think I would just park outside the ER until the four hours were up.
To yuckypeanutdad, you can get trainers from Dey, their phone number is either on their website or in the insert on the real Epipen. You used to be able to get them from FAAN, but I`m not sure if you still can. Check out their website [url="http://www.foodallergy.org"]www.foodallergy.org[/url] When I had to use the Epi in 1997, I had never seen a trainer. I am not sure they even had them then. I later practiced with a trainer, but the click is more obvious with the real one. I think what I would do if I were you is practice with a real one once into an orange. I realize you don`t have any expired ones since your child was just diagnosed, but if you do it once you can see what it looks like when you are done (the needle), and you can see how obvious the click is. I really think you would feel a lot better if you do that. I trained my daughter`s teacher and day care with the trainer, but as soon as one expires I let the teacher or day care practice into an orange. They always look really relieved after they practice with the real one "Oh, that isn`t so hard!"
Also, yuckypeanutdad, you didn`t say exactly how old your 2 year old is, and there is a big difference between just turned two compared to 2 years 11 months, but my experience with my daughter and also other people on these boards, is that these kids understand more than we think they do. So if your child is closer to turning three, he will probably understand, if you tell him he is having an allergic reaction and has to hold still so you can give him a shot to make him well. Also, I didn`t think to do this, but in other situations I always found that a big reward worked well with my daughter, even at age two. So if you think of it you could tell him that if he holds still until you count to ten, you will take him to the store and buy him a toy. Or if you really want to be prepared you could buy the toy now, put it away and then you can give an immediate reward! I know that sounds like being overly prepared, but it might help to get your child to cooperate.
I NEVER thought I would ever have to use the Epipen, until it happened. At the time, my daughter was only allergic to milk and soy, and children usually outgrow those. Milk and soy allergy are not likely to be fatal. I didn`t even keep the Epi in my purse at the time, only at home. Boy, was that stupid. It is better to be prepared.

Posted on: Wed, 07/17/2002 - 3:21am
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He is less than a month away from his second birthday. (23 months)..

Posted on: Wed, 07/17/2002 - 6:17am
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Hi - our allergist told us that we should "pin" our son to the floor when administering the epi pen. I thought that this sounded horrible. After reading ABreitner's story, though -I think I would pin him down.
I've always wondered how my son would react (he's 7.5) if we were ever in a situation where we would have to use the epi pen. When he saw the needle that the dentist was going to use to put in his freezing, he caused quite a scene and bolted down the hall, and out the door of the building before I caught up to him and brought him back.
We've been talking a lot more about the epi pen and how it could save his life. We've told him that the needle is only in for 10 seconds. But I'm still worried that he might panic and run.
Yesterday we watched the slide show that shows how to use the epi-pen ( posed above by Gail and buffalobeth). It was great. He could relate to the throat swelling slide and showed me how he's been practicing to be able to use it himself. He can't wait to show it to the babysitter tonight!
Take care [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]
Mae

Posted on: Wed, 07/17/2002 - 7:12am
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With an Epipen you don`t see the needle when you do it, only afterwards. My daughter is now 7, same age as your son. The great thing about this age is that you can explain everything to them, and they really do understand. Mae, if you have to do it, come up with a reward for your son (a big one), and he will probably cooperate. (Come up with a reward in advance.) Ten seconds is a really short time to get their cooperation.

Posted on: Wed, 07/17/2002 - 7:33am
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mae
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That's a good idea, Carefulmom! Rewards have been helpful in the past in our family, so I think it might give him some incentinve to co-operate. His reaction at the dentist suprised me ...and he was SO fast!
He's been good in the past about telling us when his throat feels funny or when he is having trouble breathing. I'll just have to trust him.
And,he asked his new allergist alot of good questions when we were there last month, which made me proud!
Thanks for the advice!
Mae [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Wed, 07/17/2002 - 7:37am
Carefulmom's picture
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Another thing to think about is that when he went to the dentist and bolted out of there he was probably feeling fine. If you have to use the Epi, he may be having trouble breathing or feeling horrible, in which case he would be much more likely to cooperate so he can feel better. If he is having trouble breathing, it will be physically hard for him to bolt.

Posted on: Wed, 07/17/2002 - 9:40am
Anonymous's picture
Anonymous (not verified)

Hi yuckypeanutdad,
Another point I wanted to make here is when all this is happening...your child gets a hold of peanut butter and you are watching the symptoms right before your eyes, your adrenaline is pumping majorly and the best thing to do is *focus* on your child.
My husband read the instructions on the side of the EpiPen Jr and *still* pulled it out before the 10 seconds were up. His primary focus was getting the medication into our son's system (adrenaline pumping) and was not concentrating on how long the pen needed to stay in. We won't make the same mistake again if unfortunately we have to use the pen again.
Everything happens very quickly in some cases and the best advice I can give is to remain focused and try to stay calm. *Easier said than done.* [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]
Welcome to the boards!
------------------
Stay Safe.
[This message has been edited by Connie (edited July 17, 2002).]

Posted on: Mon, 01/20/2003 - 9:46am
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Sue
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raising

Posted on: Tue, 01/21/2003 - 7:21am
Lidia's picture
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My son is 7 and knows about the epi-pen, but doesn't know it is a needle. Is that terrible? I thought the same thing as above. If he knew it was a needle and was having a reaction, he might not tell me what he is feeling right away because of fear of the needle. Of course, thankfully, we haven't used it on him yet.
Also, if a reward is really big and agreed upon in advance. Do you think any kid would attempt a taste of pb to get the reward? I hope not!!

Posted on: Tue, 01/21/2003 - 7:53am
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Lidia, my son told me right away during his second anaphylactic reaction, even though he remembered the needle from the first time. It's just automatic for them to tell mom. When I pulled out his epi-pen to inject him he was crying and begging me not to inject him, he kept saying it will hurt, it just about broke my heart, but I didn't hesitate for a second, knowing he needed it to be able to breath. We have now given him permission to inject himself next time, because he remembers the reaction and how quickly the needle helped him breath properly.
If your son is afraid of needles and has never experienced not being able to breath, I might keep it a little secret, until he's a bit older and maybe will need to be able to inject himself.
My son is now 8, his first anaphylactic reaction was when he was 7, and the second was only 8 months later.
------------------
Cynde
[This message has been edited by cynde (edited January 21, 2003).]
[This message has been edited by cynde (edited January 21, 2003).]

Posted on: Wed, 01/22/2003 - 9:34am
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Joined: 12/30/2002 - 09:00

Yuckypeanutdad,
I've given my daughter the epipen twice. She's 6. The first time she yelped, the second time, no complaints. If it's any consolation, both times she was extremely grateful to have gotten it. In fact, she's still mad about the one time she needed it and I didn't give it to her! She still scolds me for not taking her word for it. (As well she should!)
The best advice I got about giving the shot is to gather up a good hunk of "meat" to put the shot into -- it firms up that soft baby flesh and helps immobilize them if they jump. Both times she was lying down and I was able to lean across her to hold her in place. (Not forcefully -- just to stabilize the shot. )
And just on a personal note, I'm an easily flustered person -- but when it came to actually giving that shot, I was as calm and cool as can be. Parental focus when needed in an emergency is really amazing.
Kay

Posted on: Fri, 01/24/2003 - 3:03pm
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Joined: 08/27/2003 - 09:00

I gave my daughter the epi when she was 1 year, 9 months. It really wasn't a big deal and now I'm glad the first one is over so I'm not so scared about doing it again. She yelped and then cried a little, but got over it really quickly.
I wanted to comment on the 10 second rule. At a presentation by a Dey rep, they said that the medicine comes out immediately. The reason they say to hold it in for 10 seconds is so people don't just bounce it off the thigh. She injected one through the side of a cardboard box so we could see the needle pop out and watch the medicine squirt. It really does happen immediately. So don't worry about not having held it in for the full 10 seconds. I know using an orange is the best way to try expired epi pens, but I'd recommend doing the cardboard box thing one time just so you can see it.

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