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Emergency Use Of EpiPen AutoInjector Authorization (Prescribed Page 1) (References: P.108.SCO and PR.547.SCO, PR.548.SCO and PR.632.SCO) NOTE: Please type and submit the original, signed copy to your
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How to fill out emergency use of auto-injector

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How to fill out emergency use of auto-injector:

01
Before using the auto-injector, make sure you are familiar with its instructions and have received proper training on how to use it.
02
Start by checking the expiration date on the auto-injector. If it is expired, do not use it and seek a replacement immediately.
03
Remove the auto-injector from its protective case or packaging, being careful not to accidentally trigger the device.
04
Hold the auto-injector firmly in your dominant hand with your thumb, fingers, and palm securely around the device.
05
Find a suitable and accessible injection site on the outer thigh, preferably the middle or upper outer portion of the thigh.
06
Remove any clothing or obstruction that might hinder the injection site.
07
Firmly press the auto-injector against the injection site until the needle automatically plunges into the thigh.
08
Hold the auto-injector in place for a few seconds (typically around 10 seconds) to ensure the medication is fully delivered.
09
Carefully remove the auto-injector from the injection site. Do not touch the exposed needle to avoid accidental injury.
10
Dispose of the used auto-injector according to the manufacturer's instructions or proper medical waste disposal guidelines.

Who needs emergency use of auto-injector?

01
Individuals with severe allergies, such as those to food, medications, insect stings, or latex products, may need an auto-injector in case of an anaphylactic reaction.
02
People who have been diagnosed with certain medical conditions, including asthma or a history of anaphylaxis, may also require an auto-injector for emergency use.
03
Individuals who have experienced a severe allergic reaction in the past, even if the specific cause is unknown, may be advised to carry an auto-injector as a precautionary measure.
04
It is essential for those who have been prescribed an auto-injector to always carry it with them, ensuring quick and immediate access in case of an emergency.
05
It is important to note that specific recommendations for the use of auto-injectors and the need for them should always be determined by a medical professional based on an individual's unique medical history and risk factors.
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Emergency use of auto-injector refers to the use of an auto-injector device in situations where immediate administration of a medication, such as epinephrine, is necessary to treat a severe allergic reaction or other medical emergency.
Authorized individuals, such as healthcare professionals or designated caregivers, are required to file the emergency use of an auto-injector for record-keeping and reporting purposes.
The emergency use of an auto-injector form typically requires information such as the patient's name, medication administered, date and time of administration, dosage, reason for use, and any adverse reactions.
The purpose of emergency use of an auto-injector is to ensure prompt and proper administration of life-saving medication in emergency situations, to potentially prevent serious or fatal consequences.
Information such as the patient's name, medication administered, date and time of administration, dosage, reason for use, and any adverse reactions must be reported on the emergency use of an auto-injector form.
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