How to use an EpiPen adrenaline autoinjector — anaphylaxis first aid

Reviewed by the Medibc First Aid Team — last updated July 2026. This is general first aid information, not a substitute for an accredited first aid course or professional medical advice. In an emergency, call 000.

Anaphylaxis is a severe, life-threatening allergic reaction, and the single most important treatment is adrenaline given early via an autoinjector such as an EpiPen. According to the Australasian Society of Clinical Immunology and Allergy (ASCIA), if anaphylaxis is suspected you should give adrenaline first, then call 000 — do not wait.

Signs of anaphylaxis

Anaphylaxis affects breathing and/or circulation. Warning signs include difficult or noisy breathing, swelling of the tongue or throat, wheeze or persistent cough, difficulty talking or a hoarse voice, dizziness or collapse, and (in young children) becoming pale and floppy. Any one of these after exposure to an allergen means act now.

How to use an EpiPen: step by step

  1. Lay the person flat — do not let them stand or walk. If breathing is hard, let them sit, but keep the legs out; never stand them up (it can cause a dangerous drop in blood pressure).
  2. Form a fist around the EpiPen and pull off the blue safety release.
  3. Place the orange end against the outer mid-thigh at a right angle (90°) — it can be given through clothing, but avoid pockets and seams.
  4. Push down hard until it clicks and hold in place for 3 seconds, then remove.
  5. Call 000, say “anaphylaxis”, and note the time the dose was given.
  6. Give a second dose after 5 minutes if there is no improvement and another autoinjector is available. Start CPR if the person becomes unresponsive and is not breathing normally.
Adrenaline autoinjectors come in different brands (EpiPen and Anapen), and the exact handling differs slightly — always follow the instructions and the person’s ASCIA Action Plan on their device.

After giving adrenaline

Everyone who has an anaphylactic reaction must go to hospital by ambulance for observation, even if they seem to recover — symptoms can return. Keep the used device to hand to paramedics.

EpiPen & Anaphylaxis FAQs

Where do you inject an EpiPen?

Into the outer mid-thigh at a right angle (90°). It can be given through clothing but avoid pockets and seams. Push until it clicks and hold for 3 seconds.

Should you lie down or stand up during anaphylaxis?

Lie flat — never stand or walk the person, as this can cause a fatal drop in blood pressure. If breathing is difficult they may sit, but keep the legs outstretched and do not stand them up.

Do you call an ambulance before or after using an EpiPen?

Give the adrenaline first, then call 000. Adrenaline is the priority treatment and works best given early. Everyone needs to go to hospital afterwards, even if they improve.

Can you give a second EpiPen dose?

Yes — if there is no improvement 5 minutes after the first dose and a second autoinjector is available, give another dose into the outer mid-thigh.

Prepare for allergic emergencies. Keep a stocked first aid kit and first aid room equipment on hand. Learn more in our guides on allergic reactions and bites and stings. Fast shipping Australia-wide.

Source: ASCIA — How to give EpiPen. In an emergency, call 000.

Published: July 03, 2026