Medication Adminstration Training and EPI Pens Shortage Update - post

FDA takes additional action to mitigate shortages of EpiPen by extending the expiration date for specific lots of medication 

What does the EpiPen expiration extension mean for child care programs? On August 21, 2018, the FDA announced a limited extension of expiration dates for specific lots of epinephrine auto‑injectors. Child care directors should prioritize two actions: secure written documentation for any extended‑date devices in your inventory and verify that staff authorized to give epinephrine have current medication administration training. Enroll staff in the 6 Hour Medication Administration Training (MAT) Buy Now $89.00 and the Illness, Medication, and Allergies in Child Care Buy Now $32.00 course to meet licensing and safety expectations.

What did the FDA change about EpiPen expiration dates?

The FDA allowed a temporary extension for specific lots when testing supported a short continued shelf life beyond the printed date. This was a targeted, time‑limited action intended to ease supply constraints, not a general rule to use expired products without verification. For any epinephrine auto‑injector you receive with an extended date, obtain one of the two acceptable documents before relying on it in care: a written note from the prescribing health care provider or a pharmacy note signed by the pharmacist that identifies the lot and the extended date.

How should child care programs respond to EpiPen shortages and extended dates?

Directors and health coordinators should take these steps immediately:

1. Inventory review: Identify all epinephrine auto‑injectors on site and record lot numbers and printed expiration dates.
2. Documentation check: For any device with a newly extended date, secure the required written verification from the prescriber or the dispensing pharmacy.
3. Policy update: Update your medication administration and emergency care policies to reflect the documentation required for extended‑date devices and the circumstances in which staff may rely on them.
4. Communication: Notify parents of children with severe allergies about the supply situation, documentation requirements, and your program's plan for ensuring readiness.

These operational steps align with commonly recommended medication‑safety practices and help programs meet state licensing expectations; see our guidance on How can child care programs safely administer medication? and Child Care Medication Administration: Rules, Records, and Training for recordkeeping templates and sample consent language.

In the short term, do not accept extended‑date devices without written verification. If you are uncertain whether a specific lot was included in the FDA action, contact the dispensing pharmacy and the prescribing clinician to confirm.

Who may legally administer epinephrine in a child care setting?

Only staff who meet state licensing requirements and who have completed approved medication administration training may give epinephrine. That typically includes: staff who have the program's delegated authority, staff who hold a current medication administration certificate, and licensed health professionals when required by state rules. For program-level training options and delegation guidance, see our courses on Illness, Medication, and Allergies in Child Care Buy Now $32.00 and Allergies and Medication in Childcare Buy Now $16.00, and our article How Can Directors Train Staff on Medication Safety?.

What practical steps should staff take for safe administration during a shortage?

Trainings should emphasize three operational competencies: recognition, preparation, and administration. Staff must be able to 1) recognize signs of anaphylaxis, 2) locate the child’s health care plan and the authorized medication (with documentation), and 3) safely deliver the auto‑injector and call emergency services. Consider running a drill and updating your emergency health care plan templates; see our article How do we build a health care plan for children who need daily medication? for sample language and forms.

When supply issues persist, programs should also adopt contingency plans: identify alternate pharmacies, maintain parent communication templates, and develop procedures for rapid documentation verification. Our article How can childcare providers safely and confidently administer medication? discusses operational strategies to maintain safety when medication access is constrained.

How can I verify whether a specific EpiPen lot was included in the FDA extension?

Check the lot number directly with the dispensing pharmacy and obtain written confirmation that names the lot and lists the extended date. Do not rely on verbal confirmation alone. If the pharmacy cannot confirm, ask the prescribing clinician for a signed, lot‑specific note. File that documentation with the program’s medication log so staff can retrieve it quickly during an emergency.

Which resources and trainings will help my program comply and stay prepared?

Recommended resources on ChildCareEd include:

• 6 Hour Medication Administration Training (MAT) Buy Now $89.00 — state‑approved, in‑person medication administration curriculum.
• Illness, Medication, and Allergies in Child Care Buy Now $32.00 — focused modules on allergy recognition and medication policies.
• Allergies and Medication in Childcare Buy Now $16.00 — practical guidance on prevention and response to allergic reactions.

Also consult our related articles for checklists and administrative tools: What is Medication Administration Training and why does my program need it?, What is an easy annual training checklist for child care centers?, and How can health and safety training work in early childhood programs?.

National reporting documented that manufacturing problems caused widespread disruptions in the supply of epinephrine auto‑injectors, contributing to acute shortages for families and institutions.1 Peer-reviewed implementation studies of school health care similarly emphasize that the safety of medication administration rests on three interlocking capacities: well-trained staff, explicit operational policies, and streamlined communication channels among families, prescribers, and pharmacies.2 For programs facing limited supply, these findings translate to concrete actions: require verifiable lot‑specific documentation before relying on an extended‑date device; maintain a central, regularly updated medication inventory with lot numbers and verification status; and establish a rapid verification workflow with local pharmacies and clinicians so staff can confirm a lot’s extended date during an emergency. Implementation research also reinforces routine practice changes that reduce risk: scheduled drills, clear delegation of authority, and parent‑facing communication templates that document consent and contingency plans. Together, these measures reduce reliance on informal judgments during an emergency and create a reproducible standard of care when product availability is constrained.

Summary: What should directors do next?

1) Audit your epinephrine devices and secure written verification for any extended‑date injector. 2) Confirm that authorized staff have completed approved medication administration training—register for MAT or related ChildCareEd courses. 3) Update your medication administration policies and emergency health care plans. 4) Communicate proactively with families and pharmacies. 5) Conduct a short staff drill to confirm readiness. For templates, training, and procedures, consult the linked ChildCareEd courses and articles above.

What references support this guidance?

• Consumers Struggle to Find EpiPens — national reporting on epinephrine auto‑injector shortages and FDA attributions.
• Implementation of School Diabetes Care in the United States: A Scoping Review — evidence that staff training and system supports are central to safe medication management in school settings.

Tags: #EpiPen #medication #training #allergies #safety