Clinical evaluation of pediatric anaphylaxis and the necessity for multiple doses of epinephrine

Inoue, Naoyuki; Yamamoto, Akira

doi:10.5415/apallergy.2013.3.2.106

Cited by 27 publications

(37 citation statements)

References 23 publications

(45 reference statements)

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“…38 The association of a biphasic reaction with the severity of the initial reaction has just recently emerged as a potential risk factor. 39 23,34 Although these studies provide some insight about this association, the reported cases are too small to reliably predict this association. Also, the definition of severity used in these studies is inconsistent and not based on objective scoring.…”

Section: Previous Studiesmentioning

confidence: 81%

Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis

Alqurashi

Stiell

Chan

et al. 2015

Annals of Allergy, Asthma & Immunology

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Section: Previous Studiesmentioning

confidence: 81%

Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis

Alqurashi

Stiell

Chan

et al. 2015

Annals of Allergy, Asthma & Immunology

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“…For the critical outcome of resolution of symptoms, we identified very-low-quality evidence (downgraded for risk of bias and confounding) from 9 observational studies [77][78][79][80][81][82][83][84][85] showing benefit for giving a second dose (or multiple doses) of epinephrine to patients not responding to a first dose (RR, 1.16; 95% CI, 1.13-1.20).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 9: First Aid

Em¹,

Da²,

Buck³

et al. 2015

Circulation

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and curriculum development, and a specialist in first aid evidence evaluation methodology and guideline development.The task force convened in June 2013 to review the topics and questions that were evaluated in 2005 and 2010, past research questions formulated in the PICO style (population, intervention, comparator, outcomes) that were never completed, and the new questions that had been submitted since 2010 to the task force, and a priority list created. Topics were reviewed for areas of controversy, known additional new science, and subject matter not previously evaluated. Task force members created a priority list for review, and the top 10 priority-ranked PICO questions were assigned. After the successful commencement of the workflow, the task force co-chairs added a further 12 PICO questions, including 5 new questions, 1 derived question, and 6 that had been previously reviewed. Selected PICO questions that had been previously reviewed were, in some cases, reworded to facilitate literature searches, and outcomes were decided upon by group consensus.Evidence reviewers were recruited through a call for volunteers distributed by ILCOR to stakeholder organizations around the world. More than 30 individual reviewers were assigned to topics, usually by preference or expertise, but avoiding any direct conflicts of interest. In general, 2 evidence reviewers were assigned to each PICO, supervised by a member of the task force designated as the task force question owner. Evidence reviewers included physicians with diverse specialties including emergency medicine, EMS, wilderness medicine, critical care, cardiology, occupational medicine, toxicology, anesthesia, pediatric emergency medicine, public health, and epidemiology, as well as paramedics, nurse practitioners and first aid education specialists with experience in guideline and curriculum development, and professional evidence evaluation and methodology experts. The Evidence Evaluation ProcessFor the 2015 international evidence evaluation process, the AHA developed a new Web-based information and documentation platform, the Systematic Evidence Evaluation and Review System (SEERS), to support the ILCOR systematic reviews and to capture the data in reusable formats. This Webbased system facilitated structured reviews in a consistent format that would support the ultimate development of science summaries and evidence-based treatment recommendations.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies, 1 using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group.2 After identifying and prioritizing the PICO questions to be addressed, 3 and with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evalu...

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“…Ausgebildete Ersthelfer können bei dieser Maßnah-me unterstützen. Geben Sie allen Personen mit einer Anaphylaxie im präklini-schen Bereich eine zweite intramuskuläre Adrenalindosis, wenn sich die Symptome innerhalb von 5-15 min nach der Anwendung eines intramuskulären AdrenalinAutoinjektors nicht gebessert haben [843][844][845][846][847][848][849][850][851][852]. Auch bei einem Wiederauftreten der Symptome kann eine zweite intramuskuläre Dosis Adrenalin notwendig sein.…”

Section: Zweitgabe Von Adrenalin Bei Anaphylaxieunclassified