4. Ask your doctor if you need to carry epinephrine, and if so, know how to use it and keep it on hand at all times

Epinephrine can be injected by a parent or other responsible person in the event of an extreme allergic reaction. It could save your child's life and buy you a few minutes to get to an emergency room or to dial 911. Only your doctor and you can determine whether you need to have it on hand. It is available by prescription only.

Currently, there are two epinephrine injectors available. Ask your doctor to demonstrate the use of both brands using a trainer (pretend epinephrine injectors) to see which one you prefer. We recommend that you ask your doctor to give you a prescription for BOTH of them, because we think they are both extremely useful under different circumstances.

The EpiPen and EpiPen Jr. are basically foolproof. They are extremely easy to use once you have trained yourself and read all the materials supplied. A prescription comes with a trainer and 2 doses of epinephrine, each with its own injector. The EpiPen Jr. is what we have on hand for grandparents, babysitters and other caregivers. It is also the brand we give to the school.

The TwinJect is very compact and easy to carry anywhere. In a tube that is about the size of 1 EpiPen, the TwinJect contains 2 doses of epinephrine. A prescription comes with a trainer and 4 doses of epinephrine, with each injector containing 2 doses. After injecting the first dose, you must go through a couple of steps to get the second dose ready to use, and you'll use the same needle so you have to handle it carefully between dose 1 and dose 2. These steps are listed on an instruction sheet that is wrapped around the injector – so it's always there when you need to refer to it.
Because preparing the 2nd dose of the TwinJect is a little involved, we keep the TwinJect on hand for ourselves to administer and don't provide it for other caregivers to use. What we love about it as parents, though, is that it is so light to carry that it never feels in the way; therefore, it is ALWAYS with us. Each 2 dose injector even comes in its own plastic case with a clip that you can use to attach it to your shirt pocket or belt loop.

Which ever brand you choose, remember to do these important things:

1. Practice: Once a month, get out the trainer and practice using it on yourself. If necessary, reread the instructions and practice again so that you are always ready for an emergency.

2. Stay on top of the expiration date: When you get a new prescription, ask the pharmacist to give you one that has an expiration date of one year out. Then, when you get home, write the expiration date in your calendar a couple weeks ahead of the exp date, so that you always have a fresh one on hand.

3. Once the EpiPen or TwinJect has expired, practice using the real injector on an orange. Our daughter likes to watch us do this. It provides a good opportunity to show your child how it works and explain what it might feel like if you had to give him/her an injection.

4. Store it correctly: Epinephrine must be kept at room temperature. It should not be refrigerated or left in direct sunlight or in a hot car. Make sure the school is storing it correctly. At home, keep it in a cabinet in the kitchen so it's handy if you need it. Make sure your chosen cabinet is not above the oven or above an under-the-cabinet light due to the heat generated.
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