Kids Health Info

Auto-injectors (epi-pens) for anaphylaxis - an overview

  • Anaphylaxis is the most severe form of an allergic reaction and it is life threatening. A reaction can develop within minutes of exposure to the allergen (the thing a person is allergic to). However, with planning and training a reaction can be treated effectively by using an adrenaline auto-injector (EpiPen®/EpiPen®Jr and Anapen®/Anapen®Jr). An important part of managing and avoiding anaphylaxis is trying to prevent or avoid what causes it.

    Please read the Kids Health Info factsheet:  Allergic and anaphylactic reactions.

    Signs and symptoms of a severe allergic reaction (Anaphylaxis)

    Anaphylaxis is the term used to describe a severe and sudden allergic reaction involving the respiratory (breathing) and/or cardiovascular (heart and blood) systems. Symptoms include:

    • difficulty with breathing or noisy breathing
    • swelling of the tongue
    • swelling and/or tightness in throat
    • difficulty talking and/or hoarse voice
    • loss of consciousness and/or collapse
    • pale and floppy (infants/young children).


    The first line treatment for anaphylaxis is adrenaline that may be given as an EpiPen® or Anapen® injection for children weighing 20 kgs or more, or EpiPen®Jr or Anapen®Jr for children weighing less than 20kgs. An EpiPen®/EpiPen®Jr and Anapen®/Anapen®Jr is a single dose, auto-injector of adrenaline and is prescribed by a doctor.

    If a child has a history of anaphylaxis, and/or an adrenaline auto-injector, the following recommendations should be considered:

    • Each child who has been prescribed an EpiPen®/EpiPen®Jr and Anapen®/Anapen®Jr requires an Anaphylaxis Action Plan, completed by a doctor.                               
    • The Anaphylaxis Action Plan should be provided to the school or child care centre by the parents, together with the adrenaline auto-injector.
    • Employers should support staff training so that all staff can recognise an allergic reaction and be able to administer the adrenaline auto-injector appropriately.
    • If a reaction is suspected, the Anaphylaxis Action Plan should be followed.
    • If an EpiPen®/EpiPen®Jr and Anapen®/Anapen®Jr is given, an ambulance must be called by dialling 000.

    Excursions and camps

    The Departments of Education and Early Childhood Development have clear guidelines for taking children on excursions and camps. Schools and children's services must read these guidelines before going on any excursions or camps.

    The adrenaline auto-injectors should be taken on all excursions and a staff member trained to use them must always be present.  The adrenaline auto-injectors must always be readily accessible.

    Care of the adrenaline auto-injectors:

    • Store in an insulated container clearly labelled with the child's name.
    • Check expiry date and ensure window is clear on the EpiPen®/EpiPen®Jr regularly.
    • Store at room temperature.
    • Store in a safe, easily accessible central location.
    • A copy of the Anaphylaxis Action Plan should be stored with the adrenaline auto-injector. This will include contact details for parents/guardians and medical services.

    More information:

    This factsheet is an overview only. You will be given more information during your outpatient visit to the RCH.


    Developed by the RCH Dept of Allergy and Immunology. First published June 2007. Updated September 2012.

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This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.