epinephrine pens for asthma

Does anyone know if it is possible to give a child adrenaline via epipen during a severe asthma attack that could be given if needed before ambulance/A&E. I know how fatal asthma can be in children/babies and just having one of the these would certainly put my mind more at rest. If yes where are they available as presumably the dosage is different to adults epipens.

Thanks for any replies.

8 Replies

  • hi there, very occasionally asthmatics can be given epipens for use during an attack - usually only if they have very very sudden severe attacks on a relatively frequent basis. There is certainly a paediatric dose epipen available, and if your consultant recommended it you could get one - it is prescribably on the NHS. They are not the be-all-and-end-all though, and adrenaline has some pretty nasty side effects, so you would need to have a chat with whoever looks after sammi's asthma to see if it is the right thing to do.

  • I have a bit of thing about the way these are handed out willy-nilly these days. My daughter gets the most horrific reaction to nettle stings around the site it all swells up and takes days to go down. However, she is not anphylatic what she really needs anti-histamine and something to soothe it not an epipen. But we have been offered one countless times.

    I have been offered one more than once ""just in case"" however, I don't feel the need for one, despite having some pretty crashing attacks sometimes. There is also the issue that it is adrenaline or something close, its not to be taken lightly, my poor heart already has enough to cope with with the sub cut and stupid doses of thoephylines. If I had real anaphylaxis (sp) to something (apart for NSAIDS which I can easily control by not taking them) I woud have one. I have seen anaphylaxis close up recently and it is not pretty at all, my heart goes out to people whose lives depend on them having that pen. My life however does not depend on it and I prefer not to get into that loop as I have a feeling I would either be using it when I did not need it or more likely not bothering at all cos I would want it to be my last line of defence before totally crashing out or it might give me a false sense of security. I prefer to leave it to the Drs and paramedics to make that call for me. When I have explained this to Dr's they have been quite happy for me to carry on not having one, if they insisted or strongly recommended it I guess I would think again.


  • Very simple answer to this one:

    If your child's GP/consultant/whoever feels that they need one, they will be prescribed one.

    If they haven't been prescribed one, they don't need one.

    (For reference, none of the protocols we follow on Asthma UK's childrens holidays features epipens for treating asthma attacks.)

  • thanks so much for your advice. I have brought sammis appointment forward and we are seeing the consultant on thursday so will ask about epipens and bronchodilators. Thank you!

  • My 11 yr old has an epi pen perscribed for asthma attacks by his chest con at RBh. We didnt ask for one but told by hospital he must have one as back up while waiting for ambulance as he started having attacks where sats were into late 60's in couple mins. I certainly dont think its a drug I would give lightly and yes I also worry about putting more drugs into his body but the harsh relaity is if neb not working,he turned blue and ambulance is 15 mins away I'm not going to put his life at risk by not using epi pen. I've been told by Rbh if in any doubt to give or not I should always give epi pen, but it still a difficult decision to make.

    Ive been told its highly unusual to have epi pens for asthma and it isnt 'normal' protocol but then everyones asthma is individual to them and my son has never fitted into any asthma rule book.

  • If that is the Rbh in Reading, do let me know the name of your Consultant so I can arrange an appointment for my daughter (we'er in Slough).

    My GP thinks adrenaline is not appropriate for asthma - I need someone with more experience to educate him !

  • I have an epipen for anaphylaxis and asthma BUT i have very strict guidelines on when to use it and it is a last resort while waiting for an ambulance and even then it is not always necessary to use it.

    I have three allergic asthmatic children including one with a nut allergy which has never yet caused anaphylaxis only mild symptoms so we use antihistamines and strict avoidance of all nuts with her. I was offered an junior epipen but refused it as i felt at the time it was unecessary as she has never had a severe allergic reaction. The consultant agreed and commented that many people insist on them.

    The common view seems to be that epipens are a magic safety net cure all that is not the case avoiding the things your allergic to and good asthma control with other drugs and understanding when to get help to increase your treatment are much more important.

    There are so many drugs and steps that can be used before it's necessary to resort to carrying an epipen.

  • Hi all,

    I agree that Epipens and other adrenaline autoinjectors do seem to be over-prescribed and over-used these days. I have seen kids with them who have never had a documented anaphylaxis or severe allergic reaction of any kind. The bottom line is that adrenaline (epinephrine) is a very powerful drug with all kinds of serious side effects, including heart arrhythmias.

    I have Epipens for my brittle asthma despite having no known anaphylactic allergies, because I sometimes get sudden onset attacks that progress to unconsciousness and respiratory arrest within minutes. We would use it for an attack of that nature; however, most of my attacks, although they are rapid onset, are not so rapid that I feel the need to use adrenaline to 'buy time' whilst getting to hospital for more definative treatment (it helps that we live close by!).

    On the few occasions that I have used it, when I have felt that help might take a little longer in coming (once when on a train, for example) I have not found any huge benefit, although of course it is difficult to know what would have happened without it. These days I tend to try and avoid using it, and also refuse adrenaline from the paramedics, because it does not particularly help me and it definately does make my already racing heart even faster, which then makes A&E staff nervous about giving me back-to-back nebs and IV aminophylline or salbutamol, which do help me.

    Having said all that, I still keep the Epipens with me at all times, and my partner and family are under instruction to use them on me if I develop an attack where I lose consciousness before the ambulance arrives.

    I think the decision of whether to have one or not and when to use it is a very individual one, and needs to be weighed carefully with your doctor, baring in mind all the pros and cons. If you do get one, make sure your doctor gives you clear guidelines of when it is appropriate to use it - because using it when it is not appropriate could do more harm than good. And above all, anyone who uses an Epipen, whether for asthma or anaphylaxis, must go to hospital afterwards, even if your symptoms are dramatically improved. If you have had adrenaline you need monitoring, both by virtue of having had an attack bad enough to merit adrenaline, and because of the effects of the adrenaline itself.

    Hope this helps

    Em H

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