Frequently Asked Questions - Anaphylaxis

About anaphylaxis:

Are the signs and symptoms of anaphylaxis the same for each person?

• No, the signs and symptoms can vary for each individual.

What do we do if we suspect that someone is having an anaphylactic reaction, but has not been diagnosed and does not have a prescription for epinephrine (i.e. it is their first reaction)?

• Call 911
• Call parents/guardian
• Lay individual on their back, legs elevated. If vomiting roll them to their side.
• Await medical assistance.

Note: It is not advised to give them epinephrine if they have not been diagnosed with anaphylaxis and do not have a prescription for epinephrine.

About epinephrine auto-injector

Our organization’s policy says we must have an extra auto-injector on site. Where should we store it?

• Extra auto-injectors should be stored in an unlocked, easily accessible place.
  Note: Not all organizations require an extra auto-injector to be on site. Review your organization’s policy to be sure of what is required.

If the child doesn’t have their medication with them, what are the school’s/ recreation centre’s responsibilities?

• Once their child is developmentally able, parents are responsible to ensure he/she carries an epinephrine auto-injector on them when at school or a community recreation centre.
  Note: If you become aware that the child does not have an auto-injector with them, notify the principal/recreation coordinator. He/She will contact the parent/guardian and have them deliver the auto-injector immediately.

What if parents refuse for their child to carry an epinephrine auto-injector, do they need to sign a form?

• In schools, if the parent/guardian determines their child is not developmentally able to be responsible for carrying an epinephrine auto-injector, signed documentation might be required by the principal, each year. A staff person will be designated to make sure that the child has access to the medication wherever they may go.

Review your organization’s policy to be sure of what is required.

Does the medication in the auto-injector expire?

• Yes, the epinephrine will expire after one-two years. Check the expiration date on the auto-injector.

What if Epipen or Allerject expires?  Should we use an expired auto-injector?

• Using an expired product is not recommend because expired medication is unreliable and may not work properly. If the child only has an expired auto-injector on hand and your organization has an extra ephedrine auto injector on site use that instead. If not, the expired auto-injector should be used rather than nothing at all.

What is the difference between EpiPen® and Allerject™? Are they interchangeable? 

• Yes. The medication in all auto-injector products is the same, epinephrine. According to product instructions, the 0.30 mg dosage of both the EpiPen® and Allerject™ auto-injectors should be used for adults and children weighing 30 kg or more (66lbs+); and the 0.15 mg dosage should be used for children weighing between 15 kg to 30 kg (33-66lbs). 

How many times can you use the same auto injector?

• Just once. EpiPen® and Allerject™ have one dose of epinephrine in the device.

How long does epinephrine last? Will I need to give more than one dose?

• One dose of epinephrine lasts between five to 15 minutes in the body. If symptoms persist or reoccur after the first dose is given, a second dose may be given after five to 15 minutes.

Should we bring an extra epinephrine auto-injector on a field trip?

• Ensure the child has access to their medication at all times. Discuss with the principal/ recreation coordinator and parents to see if carrying an extra dose on field trips is required. 

About Epinephrine Auto-injector Administration

Can you use another child’s epinephrine auto-injector? 

• No, using another child’s auto-injector isn’t recommended - as he/she may need it if they experience anaphylaxis. If a student/child experiences anaphylaxis and doesn’t have their auto-injector and your site has an extra auto-injector, you can use it, ONLY if it is the same dose as the child’s prescribed medication.
  Note: Remember, it’s important that the child has access to their medication at all times. Check each day to make sure they have medication with them. If they forget it, call the parents and have them bring it immediately.

If you do use another child’s epinephrine auto injector in last resort, what responsibility do you have regarding that child, do both children have to be taken in the ambulance?

• If one child’s medication was used in last resort to treat another child’s allergic reaction, that child would be vulnerable if he/she experienced anaphylaxis because he/she would not have any medication. It is advised to take both children to the hospital, in case additional reactions occur. Also, both parents must be notified, each child must get a new prescription for medication.

If only the adult does is available, is it OK give to a child who is only supposed to receive the junior dose?

• Although it is always preferred that the child has access to his/her own medication, a larger than prescribed dose of epinephrine can be given if that is the only medication available. The child may also experience side effects like headache, vomiting and nausea.

Is it dangerous to give to a child if they didn’t need it (i.e. they weren’t having an anaphylactic reaction)?

• It’s always best to err on the side of caution. If you believe the student/child is experiencing anaphylaxis, administer the auto-injector. In the off-chance that it was not necessary, he/she may experience temporary side effects: increase in pulse rate, sensation of a more forceful heart beat, dizziness, nausea and vomiting, headache and weakness. It’s far more dangerous to not treat an anaphylactic reaction.

Should you give antihistamines such as Benadryl, or asthma medication, to treat anaphylaxis? Why not?

• No, antihistamines and asthma medications must not be used as first line of treatment for an anaphylactic reaction. While they will do no harm when given as additional or secondary medication, they do not stop an anaphylactic reaction.

After injected with epinephrine, should a child lie down, or be placed in any other special position?

• After an epinephrine injection, while waiting for medical assistance to arrive, the child should lie on his/her back, legs elevated. If he/she is having difficulty breathing, keep them in a comfortable position with their legs elevated. If he/she is vomiting, roll them on their side. It is important that the child does not suddenly sit, stand or be placed in an upright position.
  Note: Bring the medical assistance response team to the child, do not move the child.

How do you dispose of the epinephrine auto-injector after it has been used?

• Once it has been used, the epinephrine auto-injector should be given to the medical personnel to verify dose administered and dispose of safely.