Canoe trip in the morning, then a nature hike back to the campground. After lunch, basketball. Summer camp is chock-full of adventures and games, but if your child has food or insect allergies and needs to carry epinephrine auto-injectors, where should they be kept during activities?

Backpacks and fanny packs are great options, however you still must take precautions so epinephrine is safe, secure and accessible. In a recent Kids With Food Allergies (KFA) webinar, Michael Pistiner, MD, MMSc, pediatric allergist with Harvard Vanguard Associates, and Nancy Polmear-Swendris, RN, MEd, program coordinator at the University of Michigan Food Allergy Program and a camp nurse for 30+ years, offered tips for kids who self-carry epinephrine auto-injectors at camp.

When going on a water trip, pack the epinephrine auto-injector in a waterproof, floatable container or Ziploc bag. If it’s not practical to wear a backpack or fanny pack inside a canoe or kayak, then tie it tightly to the vessel, Polmear-Swendris says.

“Campers often flip their canoe over, and if the epinephrine auto-injector is not secured, it’ll be lost in the water,” she says.

Epinephrine is best kept at room temperature (68-77 degrees), but that’s not always possible at summer camp. The package insert says short-term activities in temperatures as high as 86 degrees and low as 59 degrees are “permitted.”

“If epinephrine gets too hot, it’s going to degrade the epinephrine and it may not work as needed,” Pistiner says. “On hot days, when kids need to seek shade and cooler temperatures, the auto-injectors should go with them. Don’t leave them baking in the sun.”

Epinephrine should not be refrigerated or stored with ice packs as cold temperatures may degrade the auto-injector.

“I recommend campers bring two two-packs of epinephrine auto-injectors to camp, if they are able to afford them,” Polmear-Swendris says. “One two-pack would stay with the camper and the other two-pack would stay with the camp nurse in the clinic.”

Also make sure the camp has an updated copy of the child’s Anaphylaxis Action Plan signed by a healthcare provider within the past year.

Reviewed by Michael Pistiner, MD, and Andrea Holka