Stock Epinephrine Auto-Injector Placement and Use Log

Log the placement, lot number, expiration date, inspections, and any administration of school-stocked epinephrine auto-injectors.

Log Entry Details

• Log entry type
• Entry date
• Entry time
• Recorded by
• Recorded by role

Auto-Injector Placement and Inventory

• Storage location
  Enter the specific room, cabinet, wall mount, or emergency kit location.
• Device brand
• Device dose
• Quantity on hand
• Lot number
• Expiration date
• Package and device condition

Routine Inspection and Readiness

• Storage is accessible and unobstructed
  Confirm the device can be reached quickly in an emergency.
• Seal or packaging is intact
• Expiration date checked
• Any concern about temperature exposure or storage conditions?
• Describe the storage issue

Administration Event

• Administration date
• Administration time
• Recipient age group
• Observed symptoms
• Dose administered
• Administration site
• Was a second dose needed?
• Were emergency services called?
• Post-administration notes
  Document observation, transfer of care, parent/guardian notification, and any follow-up actions.

Replacement, Follow-Up, and Audit Trail

• Replacement needed
• Replacement reason
• Replacement order date
• Follow-up actions completed
• Audit trail notes
  Add any additional documentation needed for compliance, chain of custody, or internal review.