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11/13/24, 8\:17 PM Guide | Epipen explanation

Epipen explanation

Table of contents

Introduction

Explaining the use of an adrenaline auto-injector is a common potential OSCE scenario. You will need to explain why the
patient has been prescribed an adrenaline auto-injector, when they should use it and how to use it. This step-by-step guide
describes how to explain the use of an adrenaline auto-injector in an OSCE setting.
For the purposes of this guide, the EpiPen® brand of autoinjector will be used.

Opening the consultation

Wash your hands and don PPE if appropriate.
Introduce yourself to the patient including your name and role.
Con
Check the patient’s current understanding of using an adrenaline auto-injector, allowing you to better tailor your explanation.
Position the patient so that they are sitting comfortably.

Explanation

Overview

Provide a general overview of the patient’s adrenaline auto-injector\:
“ Y o u h a v e b e e n p r e s c r i b e d a n E p i P e n f o r y o u r a l l e r gi e s a s y o u r e c e n t l y h a d a s e v e r e a l l e r gi c r e a c t i o n .
”
“ I t i s u s e d t o g i v e y o u r s e l f a d r e n a l i n e f o r t h e e m e r g e n c y t r e a t m e n t o f s e v e r e a l l e r gi c r e a c t i o n s ( a n a p h y l a x i s )”
“ T h i s i s w h a t t h e i n j e c t o r l o o k s l i k e”

Brands of auto-injector

There are a variety of auto-injector brands available including\:
Epipen®
Jext®
Emerade®
They all look slightly di
But the situations in which they should be used, and the general process, are the same.

Features of the EpiPen

The EpiPen has several features that the patient needs to be aware of\:
“ E a c h p e n s h o u l d h a v e a b l u e s a f e t y c a p o n t h e t o p , t h i s w i l l s t o p i t f r o m b e i n g a c t i v a t e d b y a c c i d e n t .
”
“ T h e r e i s a v i e w i n g w i n d o w i n t h e E p i P e n , y o u s h o u l d c h e c k t h i s r e gu l a r l y t o m a k e s u r e t h e s o l u t i o n i n s i d e i s c l e a r a n d
c o l o u r l e s s . I f t h e s o l u t i o n h a s c h a n g e d c o l o u r , t h e n y o u w i l l n e e d t o r e p l a c e y o u r E p i P e n .
”
“ Y o u w i l l a l s o n e e d t o c h e c k t h e e x p i r y d a t e a n d r e p l a c e y o u r E p i P e n w h e n t h e d a t e h a s p a s s e d , t h e r e a r e a u t o m a t i c a l e r t
s e r v i c e s y o u c a n s i g n u p t o o n l i n e t o h e l p w i t h r e m e m b e r i n g t h i s .
”
https\://app.geekymedics.com/osce-guides/counselling/epipen-explanation/ 1/411/13/24, 8\:17 PM Guide | Epipen explanation
“ T h e o r a n g e p i e c e o f p l a s t i c a t t h e b o t t o m i s t h e n e e d l e c o v e r , a f t e r u s e .
”
a n d m a k e s s u r e t h e n e e d l e i n s i d e s t a y s c o v e r e d b e f o r e a n d

When to use an EpiPen

EpiPens should be used to treat severe allergic reactions, known as anaphylaxis. You will need to explain the symptoms of this
and when the patient needs to use their EpiPen\:
“ E p i P e n s a r e u s e d t o t r e a t s e v e r e a l l e r g i c r e a c t i o n s , k n o w n a s a n a p h y l a x i s .
”
“ S y m p t o m s c a n v a r y f r o m p e r s o n t o p e r s o n , b u t t h e y w i l l ge n e r a l l y d e v e l o p s u d d e n l y a n d ge t w o r s e q u i c k l y a f t e r e x p o s u r e
t o a n a l l e r g e n .
”
“ S y m p t o m s o f a n a p h y l a x i s i n c l u d e f e e l i n g l i gh t h e a d e d o r f a i n t , s k i n , c o n f u s i o n a n d a n x i e t y , c o l l a p s i n g o r l o s i n g c o n s c i o u s n e s s . b r e a t h i n g d i
t h e n y o u s h o u l d
b e p r e p a r e d t o u s e y o u r E p i P e n .
”
“ A n a p h y l a x i s i s a m e d i c a l e m e r g e n c y a n d i s p o t e n t i a l l y l i f e-t h r e a t e n i n g, s o i t i s i m p o r t a n t t o t r e a t e a r l y .
”

Check the patient’s understanding

Ask the patient to summarise the key points back to you to check their understanding\:
“ T o m a k e s u r e y o u’ v e u n d e r s t o o d e v e r y t h i n g s o f a r c o u l d y o u t e l l m e a b o u t t h e E p i P e n y o u h a v e b e e n p r e s c r i b e d , h o w t o
c h e c k i t i s s a f e t o u s e a n d w h e n t o u s e i t . D o n’ t w o r r y i f y o u c a n’ t r e m e m b e r e v e r y t h i n g a s w e c a n go b a c k o v e r t h e i m p o r t a n t
i n f o r m a t i o n .
”

Demonstrating the use of an EpiPen

This guide focuses on the procedure for an EpiPen brand auto-injector.
Ensure you clearly explain and demonstrate the following steps to the patient using a training pen (dummy injector).
Explain that the dummy injector is safe to use on a person and does not contain a needle. They will be given a dummy injector
that they can use to train other people. They should never use their actual EpiPen for training purposes due to the risk of
accidental injection of adrenaline.

Before using an EpiPen

Before using an EpiPen you should advise the patient to check the following\:
1. Check the viewing window to make sure the solution is clear and colourless
2. Check the EpiPen is within its expiry date

Procedure

Preparation
1. Remove the EpiPen from the carry case
2. Pull o
https\://app.geekymedics.com/osce-guides/counselling/epipen-explanation/ 2/411/13/24, 8\:17 PM Guide | Epipen explanation
Epipen device
Administration
3. Hold the EpiPen in your dominant hand with the orange needle cover at the bottom\:
4. In a swinging motion, jab the EpiPen
b u c k l e s o r s e a m s o f c l o t h e s”
5. Hold it in place
w h e n t h e y a r e a n x i o u s o r s c a r e d”
“ T r y s a y i n g 1 e l e p h a n t , 2 e l e p h a n t s , 3 e l e p h a n t s t o c o u n t , 6. Remove the EpiPen and keep it with you to take to the hospital
“ B l u e t o t h e s k y , o r a n g e t o t h e t h i g h”
“ Y o u c a n u s e i t o v e r c l o t h e s , b u t n o t o v e r z i p s ,
a s p e o p l e t e n d t o c o u n t f a s t e r
Jab the outer thigh at 90°
After using an EpiPen
https\://app.geekymedics.com/osce-guides/counselling/epipen-explanation/ 3/411/13/24, 8\:17 PM Guide | Epipen explanation
7. Dial 999, ask for an ambulance and say anaphylaxis and provide your location if able to
8. Lie down with your legs slightly raised while waiting for the ambulance
9. If you have a second EpiPen you should use this after 5-10 minutes if the ambulance has not arrived yet
10. Take your used EpiPens with you to the hospital

Assess the patient's technique

Ask the patient to use the dummy injector as demonstrated and observe them.
Provide feedback based on what you observe to allow the patient to re
Point out the positives…
“ Y o u a r e d o i n g X & Y v e r y w e l l”
… then introduce room for improvement …
y o u a r e u s i n g t h e E p i P e n c o r r e c t l y .
”
“ b u t d o i n g A & B m a y h e l p e n s u r e
Continue to repeat the cycle of observation and feedback until the patient is able to use their EpiPen e

General EpiPen information

Patients should be given general information about the storage, care and use of EpiPens\:
“ K e e p t h e E p i P e n i n t h e o u t e r c a s i n g t o p r o t e c t i t f r o m l i gh t”
“ Y o u s h o u l d h a v e a c c e s s t o 2 E p i P e n s a n d y o u w i l l n e e d t o c a r r y t h e m w i t h y o u a t a l l t i m e s”
“ Y o u s h o u l d i n f o r m y o u r w o r k p l a c e a b o u t y o u r a l l e r g i e s a n d w h e r e t o
w o r k”
“ Y o u s h o u l d a l s o t e a c h f a m i l y a n d f r i e n d s h o w t o u s e y o u r E p i P e n s u s i n g t h e d u m m y i n j e c t o r”
“ I f y o u h a v e t o u s e y o u r E p i P e n s f o r a n a l l e r g i c r e a c t i o n , m a k e s u r e y o u d o n o t l e a v e t h e h o s p i t a l w i t h o u t a r e p l a c e m e n t”

Closing the consultation

Check if the patient has any questions regarding their EpiPen and when to use it.
Advise them that they may wish to purchase a medic alert bracelet or similar in case they are unable to communicate their
allergy.
Provide an information lea
Ensure they know to take any EpiPens that are expired or have discoloured solution to a pharmacy so they can be replaced.
Source\: geekymedics.com
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