It was my first day of babysitting a sweet, freckled 7-year old boy. But before his mom left, she watched as I practiced injecting an orange with an epinephrine (adrenaline) auto-injector (EpiPen). The little boy was allergic to a number of foods, including wheat, milk, egg, and nut products, and she wanted me to become comfortable with the idea of using an EpiPen. She was actually a little jittery from having accidentally injected herself in the leg while getting the supplies out for me. And she’s not alone—a recent review of 26 studies in the Annals of Allergy, Asthma, and Immunology reported there were nearly 70 incidents of unintentional injection of epinephrine over the course of 20 years. While that averages out to less than a handful of cases (OR incidents) a year, based on the evidence, researchers believe that incidents of accidental injection are seriously underreported, plus the rate of occurrence is likely increasing because more people are at risk for anaphylaxis now.

Accidentally injecting yourself may cause extreme discomfort but patients were generally okay, according to the study. Investigators recommend that people at risk for anaphylaxis, or their caregivers, get regular coaching in how to use epinephrine autoinjectors correctly and safely. Epinephrine is the drug of choice for emergency treatment of severe allergic reactions to insect stings, foods, drugs or other allergens.