Let’s talk about EpiPens. You are probably familiar with an EpiPen. These are devices used if someone has an allergic reaction, called anaphylaxis. Anaphylaxis causes swelling of the airway and inhibits a persons ability to breathe in response to an allergy. When an EpiPen is administered, the medicine can prevent the airway from closing off completely.
When to use an Epi Pen:
Often times, people jump to drastic solutions before a problem necessitates it. It’s important that epinephrine only be used when needed. Just because someone has an allergic reaction does not mean they need medicine administered. Epinephrine should be used in the event of a systemic allergic reaction. A systemic allergic reaction includes the following:
- Skin reactions (hives and itching and flushed or pale skin)
- Hypotension (Low blood pressure)
- Constriction of the airways
- A swollen tongue or throat
- A weak and rapid pulse.
- Nausea, vomiting or diarrhea.
- Dizziness or fainting.
When a person has a systemic allergic reaction, Epinephrine should be administered as rapidly as possible to stop the reaction. The medicine works to stop the reaction, but will not reverse the reaction, so time is crucial.
Epi Pens can be reused? Fact or Fiction?
It is widely believed that an EpiPen has additional amounts of epinephrine in it, even after it is used. Most Epi Pens have .3 mg of Epinephrine. It’s rumored that after use there is up to .2 milligrams in the auto injector.
To find out, we had a Nationally Registered Paramedic take a look. To find out if this was true, he cracked a used Epi Pen open. Of course, we should mention that replicating this is not advised. A used epinephrine pen will have an exposed used needle. Once used, these should be disposed of in a sharps container.
As soon as the Pen is cracked open, a spring comes out and the epinephrine vial is exposed. A substantial amount of epinephrine was still in the vile. (Approximately .2 milligrams)
However, if you attempt to pull the vial off the needle, there is a stopper that does not let the needle push any further. (See Video below for demonstration)
Fact: Epi Pens still have epinephrine after use.
As it turns out, it is not a myth that Epi Pens have more epinephrine after use! You actually do have extra epinephrine, which can be handy in a last-ditch survival moment. While most people only require one epinephrine pen, occasionally there are people who are prescribed two EpiPens. These individuals have reactions that are so severe where two pens may be needed.
If you run a situation where an individuals airway continues to close after epinephrine is administered, and all you have is one EpiPen, now you know you can break it apart and administer them more epinephrine. Reusing the epi pen should only be done on the same individual to reduce the spread of bloodborne pathogens.
When reusing an epi pen, we would not recommend pushing all of the epinephrine out at once, but doing little bits at a time in increments. Approximately a third of the vial remains after first use, and pushing a little bit of it at a time until the patient experiences some relief could be the difference between life or death.