In May 2016, the FDA released updated instructions for the usage of epinephrine auto injectors. The updates include shortening the length of time it takes to use the pen and highlight some of the potential risks associated with the use of auto injectors. Here is a condensed version of the recent changes as noted in the patient instructions for EpiPen and EpiPen Jr.:
1. Limit movement of the leg during injection
This is especially important in children as they may jump or kick during the injection. Movement during the injection can cause bent or broken needles which may cause significant tissue damage and increase risk of infection.
2. Hold injection for 3 seconds
Previous instructions for auto injectors have stated that the EpiPen must be held in position for 10 seconds in order to ensure the delivery of medication. Delivery of epinephrine does occur quickly due to the the force provided by the injection. Three seconds has been determined to be an adequate amount of time to hold the EpiPen in position, which may also significantly reduce the instance of injury as a result of bent or broken needles.
3. Potential of infection at injection site
The updates also include information for patients to return to the hospital if signs of an infection present after injection. Although serious infection is not common, it is important to consider and to pay attention to the healing process at the injection site. The current recommendations add emphasis to only using the EpiPen on the lateral (outside) aspect of the thigh and not in the buttocks, intravenously, or in the hands and feet.
Additional Epinephrine Auto Injector Information
Revised May 2016 EpiPen and EpiPen Jr product information - Mylan
Storage of Epinephrine in Remote Environments - LWM
Identification of Epinephrine Auto Injectors - LWM
Epinephrine: Medical & Ethical Necessity or Legal Nightmare - OutdoorEd.com