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Adrenaline Injectors in First Aid Kits

Person holding a mobile first aid kit

First Aid Kit and Adrenaline

Does your workplace first aid kit have an adrenaline injector that can be used on anyone thought to be having a severe allergic reaction known as anaphylaxis?

Having an adrenaline injector for general use (not prescribed for a specific person, that can be used on anyone) in a workplace first aid kit should not replace an individual’s prescribed adrenaline injector. Please note that an adrenaline injector can be administered by anyone in the workplace. In fact the person experiencing anaphylaxis may be too unwell to give the adrenaline injector to themself.

This adrenaline injector for general use should be stored with an ASCIA First Aid Plan for Anaphylaxis that is specific to the brand autoinjector that you have in the workplace first aid kit. The First Aid Plan for Anaphylaxis guides the emergency response.

When deciding whether to have an adrenaline injector in a workplace first aid kit a risk assessment should be completed. The risk assessment should consider whether there is an increased risk of the following in the workplace:

  • A person in the workplace more likely to be exposed to allergens known to trigger anaphylaxis (e.g. bees, wasp, jack jumper ant). High risk environments such as beekeepers should consider having an adrenaline injector available, even if no worker has previously had an allergic reaction.
  • A person, previously undiagnosed, having anaphylaxis (such as during a large-scale event where food is being served/available for purchase). The more employees there are in a workplace, the greater the chance someone might have their first anaphylaxis.
  • A person known to be at risk of anaphylaxis not having their personal adrenaline injector available, accidently misfiring the injector or the injector having expired.
  • A second or third dose of adrenaline being needed to treat anaphylaxis before medical help arrives at the scene.
  • Difficult access to a worksite for emergency services or the geographical location of worksite (distance from emergency services).

If a workplace has an adrenaline injector in a first aid kit, staff need to be trained in when and how to administer the adrenaline injector following instructions on the ASCIA First Aid Plan for Anaphylaxis. Free e-training in anaphylaxis management is available from the Australasian Society of Clinical Immunology and Allergy (ASCIA).

A short video on how to administer an Anapen® can be found here.

A short video on how to administer an EpiPen® can be found here.

Mobile First Aid Kits

Mobile first aid kits are used in workplaces where staff undertake their work away from an office building. This might include workers such as beekeepers, park rangers, miners, farmers, surveyors and school staff and students when on excursions or camp. If these mobile first aid kits contain adrenaline injectors (EpiPen® or Anapen®), it is important to know how to store them so that the adrenaline injectors are kept out of extreme temperatures when possible and the dose of adrenaline in each device remains stable. This means the adrenaline injector will work most effectively to treat anaphylaxis in an emergency.

Storage of adrenaline injector in first aid kit

  • The adrenaline injector must be stored where it is protected from direct heat and light, ideally at room temperature (between 15-25 degrees Celsius). 
  • An ASCIA First Aid Plan for Anaphylaxis should always be stored with the adrenaline injector. EpiPen® and Anapen® have specific ASCIA Action Plans, so the correct plan must be stored with the correct adrenaline injector.
  • The shelf life of the adrenaline injector is normally 1-2 years from the date of manufacture.
  • The expiry date marked on the side of the device should be clearly marked on the outside of the first aid kit.
  • There must be a system in place to document when adrenaline injectors are due to expire so that a replacement can be purchased.
  • Timely replacement when an adrenaline injector has been used is also important.
  • Expired adrenaline injectors are not as effective when used for treating anaphylaxis. However, if no other adrenaline injector is available, a recently expired adrenaline injector should be used in preference to not using one at all.

Storage issues specific to mobile first aid kits

All the above instructions for general workplace first aid kits apply to mobile first aid kits. The following must also be taken into consideration for mobile first aid kits containing an adrenaline injector:

  • DO NOT leave the adrenaline injector in the car when you are not in it as the adrenaline injector can overheat or become too cold.
  • DO NOT leave the adrenaline injector in a car fridge or next to an icepack as it will get too cold, and this may affect the automatic firing of the device in an emergency.
  • When the adrenaline injector will be exposed to extremes in temperature (very hot/cold for many hours/days) it is BEST PRACTICE is to use a specially designed pouch which will keep the adrenaline injector at room temperature for a number of days, such as the Frio® or MedActiv® products. These products are available through the Allergy & Anaphylaxis Australia online shop.
  • ALWAYS take the mobile first aid kit containing the adrenaline injector out of the car and have it with you. On a hot day, leaving it in the car will be even hotter than having it with you. Keep it in the shade or the coolest place possible without refrigerating it. Not only does this help keep the adrenaline injector at the correct temperature, but it means that you will be able to access the device quickly if you/workmate have an allergic reaction. If you are experiencing anaphylaxis, you need to lie or sit down with your legs outstretched and administer the adrenaline injector as soon as possible, then call triple zero (000). Walking/running to get the adrenaline injector when having anaphylaxis means you can become more unwell very quickly as your blood pressure can drop suddenly.
  • At the end of the workday/excursion, the mobile first aid kit should be removed from the vehicle and stored in the officeaway from direct heat and sunlight.

Allergy & Anaphylaxis Australia (A&AA) has helpful information about adrenaline and temperature control.

ASCIA has helpful information about general use adrenaline injectors.