The Emperor has no symptoms: the risks of a blanket approach to using epinephrine auto-injectors for all allergic reactions
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Published version
Author(s)
Turner, PJ
DunnGalvin, A
Hourihane, J
Type
Journal Article
Abstract
Fatal anaphylaxis in humans is rare and unpredictable. We note a trend to provide allergic individuals with care plans that recommend immediate use of epinephrine autoinjectors if allergen ingestion is suspected, even in the absence of any allergic symptoms, without any supporting evidence base. Instructions to use an autoinjector device, irrespective of reaction severity and especially when symptoms are actually absent, are likely to add to parental and patient anxiety. Of greater concern is the possibility of epinephrine being administered “too early” to treat initial, mild symptoms that then progress to severe anaphylaxis. It is not hard to visualize a scenario where one or both epinephrine autoinjectors have been deployed for mild symptoms, yet the reaction progresses to a severe reaction and no further epinephrine is available for administration. Epinephrine needs to be available as a rescue treatment for anaphylaxis, potentially buying valuable minutes while emergency medical services are activated to attend. Food-allergic individuals and their carers need to be provided with more constructive strategies and support than merely being told to “use your pen.”
Date Issued
2016-06-07
Date Acceptance
2016-05-06
Citation
Journal of Allergy and Clinical Immunology: In Practice, 2016, 4 (4), pp.1143-1146
ISSN
2213-2198
Publisher
Elsevier
Start Page
1143
End Page
1146
Journal / Book Title
Journal of Allergy and Clinical Immunology: In Practice
Volume
4
Issue
4
Copyright Statement
© 2016 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Sponsor
Medical Research Council (MRC)
National Institute for Health Research
Grant Number
MR/K010468/1
RDD02
Subjects
Anaphylaxis
Autoinjector
Emergency management
Epinephrine
Food allergy
Publication Status
Accepted