
Get the free Self Administrated Epi Pen and asthma-inhaler form.doc - houstonisd
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Houston Independent School District
Health and Medical Services
Policies Governing Self-Administration of Prescription Emergency for Treatment of Asthma
Medication and Life Epinephrine while on School
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How to fill out self administrated epi pen

How to fill out a self-administered epi pen:
01
Remove the cap: Take off the blue safety cap by pulling it straight off the top of the epi pen. Make sure the needle end is not covered.
02
Hold it firmly: With the orange end pointing downward, hold the epi pen with your fist around the middle of the device. Do not touch the needle end.
03
Swing and jab: Swing your arm like a baseball pitch and quickly jab the needle end straight into the thigh. The epi pen will activate automatically upon contact.
04
Hold in place: Keep the epi pen in place for at least 10 seconds, allowing the medication to be delivered. Then, remove the epi pen from the thigh.
05
Seek medical help: Even if symptoms start to improve, it is important to seek immediate medical attention after using the epi pen. Call emergency services and inform them about the situation.
Who needs a self-administered epi pen?
01
Individuals with severe allergies: People who have experienced severe allergic reactions, known as anaphylaxis, in the past are often prescribed a self-administered epi pen. This can include allergies to food, insect stings, medications, or other triggers.
02
Those with known allergies: People diagnosed with allergies that have the potential to cause anaphylaxis may be advised to carry a self-administered epi pen as a precautionary measure. This includes allergies to nuts, shellfish, latex, or other common allergens.
03
Individuals at risk: Some individuals may be at higher risk of experiencing severe allergic reactions due to their medical history or other factors. In these cases, a healthcare professional may recommend having a self-administered epi pen on hand in case of emergencies.
It is essential to consult with a healthcare professional for proper guidance on the use and necessity of a self-administered epi pen, as well as to receive adequate training on how to properly administer the medication.
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What is self administrated epi pen?
A self administrated epi pen is a medical device used to administer a dose of epinephrine in case of severe allergic reactions.
Who is required to file self administrated epi pen?
Individuals who have been prescribed an epi pen by their healthcare provider are required to possess and carry it at all times.
How to fill out self administrated epi pen?
To fill out a self administrated epi pen, remove the safety cap, place the tip against the thigh, and push down firmly until it clicks.
What is the purpose of self administrated epi pen?
The purpose of a self administrated epi pen is to quickly deliver a dose of epinephrine to prevent or treat severe allergic reactions.
What information must be reported on self administrated epi pen?
The epi pen should have the individual's name, the expiration date, and specific instructions on how to use it.
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