Epi Pens: When, Where, and Why to Use Them

[@thecowboy8474]

Story time, my wife is a paramedic and she brought some trainer EpiPens home a few months ago. Ive practiced with them several times in the past. My brothers came over this past Sunday and saw the trainers sitting by the TV. We talked about them and I picked one up to demonstrate how they work. So I popped the tab, twisted off the cap and sent it home into my leg. I attempted to show how the sheath would retract into the pen to expose the needle if it was actually there, but it wasn't retracting anymore so I thought I had broken the trainer. I grabbed the second one and realized there was a sticker seal on the lid... And a little gray piece of rubber sticking out. I took a closer look at trainer pen I just hit myself with and found a needle in that one too. So I excused myself, went to my bedroom, pulled down my pants and found a little hole in my leg. Turns out my wife had gotten rid of the trainers and was keeping her Epipens there instead. And my dumbass self didn't read the fine print.

[@Daniel-wy2kx]

What were the Ill effects??????

[@thecowboy8474]

@@Daniel-wy2kx I started getting anxiety, at first I thought it was because I wasted about $600. But it was just the adrenaline. Next was the shakes but that wasn't bad. My heart rate increased but again not to an extreme degree. By far the worst part was the crash that happened about 30 minutes after injection. I felt pretty bad out of the blue. Like I was fine and the BAM it hit. After another 15 minutes or so it got WAY worse and lasted about 30ish minutes before I felt better.

[@lukearts2954]

Sincere question: were you drunk at the time? I mean, shoving a needle into a muscle is not something that goes unnoticed... Even when it's done manually, very carefully by a trained pro, it still often hurts, and the tension of the liquid forced in between the fibers feels like a bad bruise. So when you do it yourself at a random location of your quads, I find it hard to believe you didn't notice instantly unless you were sensory impaired at the time, by alcohol or drugs... So sorry to hear it's $600 for you. That's what you get from refusing basic obamacare. We have universal health care and before insurance, they cost me $25 a piece, of which I get 20 back from my optional medical expenses insurance. So it's only a $5 investment in the end. Still, that's 3 days of food or 2 months of opiate painkillers, so I consider them expensive.

[@thecowboy8474]

@@lukearts2954 my sincere answer is I literally didn't notice until about 3 minutes afterwards. That was the main reason I didn't really believe I had just used a real one. I figured I would have felt the needle. I had to check for a hole in my leg before I accepted I had just injected myself with an actual pen. I was getting ready to go out to dinner with my brothers so no drugs or alcohol were involved.

[@lukearts2954]

@@thecowboy8474 yea, sorry I had to introduce my comment like that, but I feared otherwise it could be interpreted as some condescending criticism, which it definitely wasn't. And I'm glad that you live somewhere where getting ready for dinner does not involve alcohol by default. I'm less fortunate, and that's one of the reasons why I don't go out anymore: it seems nobody's able to enjoy themselves without being drunk or numbed to detach from the work stress and other misery in life. I think I can see how disbelief could make you doubt the pain you must have felt. At least it was in the right spot =) Another good training session ^^

[@ok9nja741]

Thanks for a great video. My girlfriend is an allergic and carries EpiPen in case of an anaphylactic reaction. I was told about EpiPen in BLS class I went to some time ago but it was very superficial (take the rear cap off, stab the patient in the thigh, moving on to another topic). Keep up the great work, your channel gave me a lot of interesting medical information.

[@NeilAmbroseUK]

My daughter suffers from food allergies and was accidentally fed one of her allergens at nursery school. The staff panicked and one staff member injected her own thumb, exactly as you demonstrated. She was pregnant at the time so shared the ambulance to A&E (the ER) with my daughter! Great video.

[@taylorclay2122]

My kiddo and I both have dairy allergies and I have anaphylactic reactions to latex. THANK YOU for this video!!! THANK YOU!!

[@taylorclay2122]

Something my allergist taught me was the saying, “blue to the sky orange to the thigh” to remember what goes where.

[@aftbit]

That's kinda cute, but the rhyme is just sky to thigh, so one could easily mis-remember that as "orange to the sky blue to the thigh" and waste the epipen into their own hand instead of applying it properly to the patient. I guess it helps that the sky is blue.

[@Youtubeparolee]

Thanks for the refresher. I was trained to use these during the Persian Gulf war in 1990. I was just prescribed these today by my doctor.

[@ashlandwest1647]

Thanks for the great video! I carry an Epi and have found many people don't know what it is, much less how to use it. I even had security try to confiscate it at an event because they didn't even know what an EpiPen was and thought I might not be allowed to bring it inside.

[@roastawk]

One point I learned was to make certain to preserve the used auto injector so it can be handed over to EMS or emergency care givers. I checked my wilderness first responder training material in case I had forgotten, but this point is not addressed. Thanks for filling in a seeming omission.

[@blakslee720]

This is getting eerie. Your acronyms video came out shortly after my class did the medical terminology chapter. Now you're doing Epi 1 week after we did it.

[@mikeday5776]

A suggestion, I’m on the extreme end of anaphylaxis, write down the time of injection. In a stressful situation people’s time awareness can compress or stretch. Great video, thanks 👍🇬🇧

[@knifetech101]

My gf has an egg yolk allergy and always Carrie’s one around with her. We’ve talked about how and where to use it, but good to get a refresher.

[@lukearts2954]

I carry one of those, and mine expired in the spring of this year. When talking to my doctor to get a new prescription, she told me that as long as it's not discolored yet, it should still be fine even more than a year past expiry date. I'm not going to go more than 1 year past, though, but it surely makes a difference in the wallet to extend the use. It was prescribed to me after a series of anaphylactic episodes after ingesting seafood, more specifically all shrimp-like things like prawn, lobster,... (it took a long time to identify the culprit) and the last time I had to be taken into the E.R. while I was keeping my throat open with a finger in order to keep breathing. At that point the doctor said I should carry an epipen at all times because it's really not worth the risk, especially because the reactions got more severe every time. I'd still have to go to the E.R. but at least I won't have to stick my finger in my throat risking inhalation of vomit and whatnot. For the slower episodes I also carry methylprednisolon (Medrol). It's a bit tricky because if I misidentify a heavy reaction for a slow one, the more serious effects could be masked for a while (making me think I'm okay, and go to sleep only to wake up choking after a few hours) and put me in more trouble. It's really no fun having to be mindful of all your allergens in the environment. But by doing so, I have been able to avoid a serious episode ever since the epipen was prescribed, meaning that I haven't had to stick myself just yet. Yay! haha. But surely I won't be able to avoid them all. That very last one, for example, was after a dinner in a restaurant where I had stated my allergies and I had been very careful. My date even took them into consideration when making her choice. But it must have been a cross-contamination from an unclean working surface in the kitchen or a mixed use of frying oil. Both of which would have been infractions of local hygiene and food security code, but hard to prove. TL;DR I'm a carrier. My doctor said it's ok to use past expiry as long as no discoloration.

[@bassbrayden9183]

Really helpful!!! I’m in school for EMT and just had a lecture on anaphylactic reactions today!

[@maddog980]

Cool!

[@ZIggyRIbetto]

Watched a student in my emt program (after we were explained how to use the device) cover the need end of an autoinjector with their thumb, and depress the wrong end into their thigh. The device triggered with their thumb over the needle side... Thank god for training devices

[@RMSVA]

This is an outstanding introduction and overview! Is there any chance you could continue going through the ALS drugbox and do similar videos for a lot of the other comment ones?

[@majortester7293]

i'm a lifeguard, was never taught how to use an epi pen, thanks for the vid.

[@newhampshireoutdoornetwork9505]

Thanks for making this video one of the guys I work with carry these due to a bee allergy. Now I know I can help him without worry of did I do it right .

[@FuttBuckerson]

Good looking out, I hope there are more folks like you!

[@Redhood91007]

"This is not a training platform" then proceeds to basically train for an epipen use

[@EWDAVID94]

Any plans on doing one of these on narcan?

[@Jack-sf5yp]

Thank you. Is admin in left leg preferred to right leg? If 2nd dose is required, should it be given in the same or alternate leg where 1st dose was administered? Have leaned much from you over the years!! Thanks so much!

[@HairpinMagazine]

Theoretical question: there is a child in anaphylactic shock. And one have only the adult dose. To inject it, or not? Or keep it in a leg for 1.5 sec and hope that only half of the dosage was administered?

[@emyleewong3600]

Perfect. I give you a 10. Thanks 🙏🏿 so much

[@Jeremy-km4dj]

Hi sir. what do you think of the Israeli bandage? would you do a video on it?

[@cmcer1995]

Great review on Epi Pen and education on how to use and not use.

[@Kez_abi]

Thankyou very much for making this video. Especially for covering the heart thing. I had an asthma attack October 21 they gave me epinephrine IM and I have WPW heart condition and it did effect my heart but it saved my life. 🤷 Very recently I was wondering if you had a video on this.

[@86aidan31]

Quick question to Sam or anyone else that knows. If someone was to need a second dose of epinephrine after 10-15 minutes like he mentions, would it be best to inject that second dose in the other thigh or the same one. Probably doesn’t matter much but I’m curious 😅

[@christianschafer3724]

One of the few videos where the pen is handled correctly.

[@bishopm4401]

People complain about getting ads? Or you having an intro? Tf? Anyway. I have been trained on this, but we could always use refreshers. Thanks for the video!

[@skinnyscouter]

Do A video on Glucagon for low blood sugars

[@florences2153]

Great very interesting advice, thanks so much.

[@mattkarl8578]

Is there any legal concerns about using an epipen on someone it's not prescribed to. For example, I'm hiking in the woods, I come across someone who is having trouble breathing and they tell me the got stung by a bee and are allergic. I administer my epipen to them. Could there be legal problems with that?

[@mannyzuccarelli]

Amazing content brother, thank you.

[@AnAmericanPatriot1555]

Is it wrong that I don’t want to carry narcan in my personal med kit? EPI? I wouldn’t have a problem if I were authorized.

[@junkmauler]

Is it safe to keep one in my glove box? I'm only asking because it would be the best place for one of my epipens.. but does it get too hot in a glove box?

[@MADGYPSY69]

Do you give zoom classes?

[@shaqattac]

What would you do with someone experiencing anaphylaxis affecting the airway and breathing without an epi pen? (I know you’re a paramedic so you have it in viles) but how would an EMT handle it before ALS arrives? Would NPA/OPAs and BVM work with an obstructed airway?

[@PrepMedic]

EMTs can give Epi every state I have worked in. Can you not?

[@Jan_2000]

@@PrepMedic At least here in Germany, no. Only Paramedics are usually allowed to give more than Oxygen. EMTs do it in some cases (especially in volunteer unit, where paramedics are rather rare), however it is ona rather shaky legal base. Basically illegal by default, unless you can justify it by having to violate it in order to protect a higher right (analogy to self defense basically). That being said, EpiPen would be almost certainly ok to use if indicated, but it comes with a legal risk for the EMT if things go wrong.

[@manuelschmidt1081]

@@Jan_2000 I know at least to systems were an Rettungssanitäter is officially allowed to administer Epinephrine I.m. Every EMS standards I know aren't made for EpiPens. They're made for manual administration of Epinephrine. I'm pretty sure: were EpiPen used in EMS here, there would be more systems where a Rettungssanitäter would be officially allowed to use the EpiPen.

[@bonnieparker1238]

Dang! That was a great video! Thank you

[@roundtheworld2702]

Is the “second dose or the second hit to the thigh “ from one pen ? if there’s a reoccurring situation

[@dianamitchell7410]

Yes can u Sis this if u are allergic to Bactrim?

[@caryvanarsdall3957]

@prepmedic I've got a question from a call I got yesterday. I'm part of a very active volunteer fire department and we do run a lot of medical calls due to the small number of ambulances in the area. Our call came across as a juvenile that had accidentally injected themselves with an epi-pen. I am working toward my EMT and didn't make the call because I was on the other side of town, but I wouldn't have known what needed to be done on-site for that patient. Understanding that they are going to need transport, what would a responder need to do once they arrive prior to transport?

[@peterodriscoll2645]

Hey Sam, can you make a video on neonate, infant, and adolescent vital signs? Thanks!

[@stevehisey389]

Anterior/ lateral thigh vs medial ?

[@65BravoS86]

The 1k like 😁 Great content. Thank you Sam

[@jackfis1]

regarding the second dose... is the epi pen a single dose or can you administrate multiple doses (how many) from the same one ??

[@JohnHolliday1911]

Great video

[@witcheddoctor2720]

Got a mad anaphylactic reaction in bootcamp when running on the track 2.5 years ago, entire body started swelling up badly and lose of motor control and conscious from here and there. Got like 5 EpiPens injected into my right inner thigh, near the groin, on the way to the ER lol. I don't have any allergies but it is strange.

[@benyoung7715]

Quick question: I'm allergic to bees, wasps, etc. I'm a retired veteran so every year before hunting season my VA doc makes sure I have current pens. If I have to use a pen while hunting can I move myself off the mountain or do I need to stay put and call for help?

[@PrepMedic]

Nah, get yourself out of there

[@benjamincooley1606]

Thanks for the video! I carry epi pens because I had a rough reaction to a couple bee stings. Just as question: if one of my children were to go into anaphylaxis would it be a bad idea to use my adult epi pen (0.3) for them if that’s ALL I had on hand? Or would the dose be dangerous? Again in this scenario that’s all that is on hand

[@waynesilva3129]

When I bush walk I carry two epipens with me. If I'm bitten By a poison snake. I'm going to pump myself full with both pens. I asked a doctor and he said I can't see how it would affect the body. I'm sure this will attract lots of controversy. What do you have to lose when your waiting for help.

[@ukraine_tbic]

What is your honest opinion on expired? I’m sure 6 months is ok, but say a year or two? I’ve only ever administered once, and all we had left expired in 2018…. Not good

[@Mark-qt5ux]

Awesome!💚💚

[@Eliza.--.]

I don't know if this is still the case, but isn't anyone suspected of having an anaphylactic reaction supposed to go to the hospital ASAP, regardless of whether they've received epinephrine? You did imply this, but didn't say it outright, so I thought I'd ask. Thank you for another great video!

[@darthryking]

Yes. If you need to administer epinephrine, or even suspect you may need to administer epinephrine, the patient needs to go to the hospital. You don't know if the reaction will get worse or come back.

[@alliwantisfinancialstabili7414]

It's allergy season and my sneezing has gotten so bad that I'm here to learn how to use epi pens to fight my allergies because evidently Nasacort doesn't cut it. /s Just here because first aid is an interesting topic and I wanna learn how it works out of curiousity

[@rja9784]

I shouldn’t have waited to research this while I’m in anaphylactic shock. Goodbye cruel world

[@3Runner95]

what if someone used it just for the hell of it, what would happen? Would it be like a powerful stimulant?

[@mm-zd9ml]

If it is has 0.3 milliliters is has 300 milligrams??? Or not?

[@gofortitwithcody]

If a second dose is needed to be administered. Should it go in the opposite leg or does it not matter?

[@taylorclay2122]

On a small kiddo I’d use the other thigh, but on an adult I wouldn’t think it would matter. My allergist taught it this way, draw imaginary lines in thirds on the thigh and aim for the middle one :). I am in no way a medical professional, this is just what I would do

[@craigcottingham35]

I often wonder why there isn't a epi-pen for first response pulse less arrest.

[@charlieromeoone5302]

Interesting. In the UK, we don't massage after administration and haven't for some years

[@JRMoore]

Do you know the reason for that change? Is it better to not, or just not significantly better if you do?

[@charlieromeoone5302]

@@JRMoore no idea. The change came in a few years ago from the manufacturer. I'd assumed this was worldwide.

[@timvashchyshyn8656]

Ukraine doesn’t have them right now but it’s definitely a must know on how to use.

[@Radegastly]

I want to stress knowing when to use one of these because I have been given one when I didn't need it as a young child since my mom's friend who was in nursing school thought I got stung by a honey bee and was having an allergic reaction, I had a rash. My poor heart was racing like I was having an anxiety attack, my one leg couldn't stop swinging since I was sat down on a chair. That was the scariest day of my life that I can remember. Also please know that some people like myself don't need their Epi Pen right away but PLEASE MONITOR THEM to see if they need it. Yes I can be stung by a honey bee and not go into anaphylactic shock but there are people out there who aren't that lucky and WILL go into anaphylactic shock not too long after the honey bee stings them.

[@leslieunderwood3520]

Quite the intro disclaimer. Were you anticipating a slew of 'Lunch room Lawyers' bombarding the comment field? ;)

[@jtcool8162]

Hmmm.... I thought it was 10 seconds for brand name EpiPen.... And 3 seconds for the auvi-q type.... Other then that excellent knowledge dump as always... Appreciate the videos!!

[@PrepMedic]

It used to be but EpiPen changed their information.

[@Eliza.--.]

The advice I got when learning to use an epipen was to count to 10, even though it says 3 seconds. The reasoning was that under stress, people often count too quickly, and it would be better to press for too long than risk the patient not getting enough epinephrine.

[@jtcool8162]

@@PrepMedic very interesting.... Glad to know... Been a long time subscriber... Your videos help me through EMT school... Keep it up!

[@taylorclay2122]

@@Eliza.--. this was what I was taught as well! And each system is different so holding the device for 10 seconds will guarantee that regardless of brand all medication has been administered

[@Anakin-Skywalker.]

Good video

[@ericlondon5731]

At 20 y.o. age, I developed a severe anaphylactic reaction to COFFEE ! I have met one other person who has this, they are a medical office worker.

[@ruebeng2]

Weird to think I got hired on to the same agency as you lol

[@HogwartsBasement]

Remember you can get a trainer for free from the manufacturers website for ANYONE

[@cowboypenguin]

EpiPen1s?

[@cade8986]

Is it ever appropriate to inject anywhere other than the thigh? Deltoid for example.

[@hesherson]

Yes, you are able to use an epi pen on the deltoid.

[@CWebs]

Friend of mine administered 7 epi shots to her in a 30 min. time span… 😬

[@DH-.]

What do common people have available if there is someone over dosing on drugs?... Pulp fiction curiosity

[@derek8838]

These pens are sold as a one time dosage. Watched a KZbin clip showing that there is actually another 4 doses in the pen. At the price they are sold at, for supposedly 1 dose. ???

[@meidamx]

Get some.

[@coreyletson2410]

Well I’m having a reaction and my wifi is really lagging. Maybe if you didn’t shoot a ten min long intro in 8k I would not look like the Pillsbury Doughboy right now………

[@mrofefilmodnar5884]

Good to know how to use them, but i wish instead of doing 5 minutes of damage control you would instead explain how to recognize when somebody is having a anaphylactic shock, so that I don't inject somebody having a heart attack with epi

[@midnull6009]

Remember, if you are going to administer epi pen on somebody else have their had on the pen first then your hand on top. Else, you can be sued for assault. :) Also, remember to check w/the person who is going into shock that they don't have DNR, else you'll be sued. :D

[@PrepMedic]

I wouldn’t give legal advice on the internet if you don’t actually know the laws. A DNR is not a “do not treat” and treating them for an acute issue such as anaphylaxis will not violate the form. Furthermore in the absence of the actual paperwork for a DNR full resuscitation is still performed until it can be procured. As far as wrapping someone’s hand around an Epi pen and “helping” them do it, either way you will be almost assuredly covered under Good Samaritan laws and will not be sued or charged with anything.

[@adamblackman6660]

If you happen to be in Mexico, you may be able to buy these for 10$ US… over the counter. Just fyi.

[@PrepMedic]

Mexico also has notoriously horrible pharmacies that sell as many counterfeit and expired medications as they do real ones.

[@dracofalconis7865]

Big needle + thigh = weeee!!!

[@rodneytuxedo7559]

Hold up, are you guys saying that evolution doesn't exist? This video is confusing........

[@mikemaner8499]

Your picture showing the epi pen through the pants is absolutely horrible. Don’t you know using an epi pen through clothing is a massive no no. You can have a piece of clothing become injected into the blood stream and create a thrombus which obviously can lead to numerous other medical problems. Maybe leave these procedure to the TRUE professionals….

[@PrepMedic]

Lol I love you mike

[@coreyletson2410]

😂😂😂

[@sonofamerc]

I know a word you can spell out of epi pens

[@flipside1767]

please add ukrainian subtitles

[@mahzorimipod]

medical advice from fascist adjacent

[@PrepMedic]

Thanks for the engagement! Cheers!

[@johnjacobjinglehimer4568]

I am aware that you are not a licensed physician thank you

[@aaroncapricorn5867]

a "licensed physician" is statistically much more likely to kill you and take bribes from big pharma. argument destroyed

[@halo2time]

Great video