Epinephrine in the Management of Anaphylaxis

Brown, Julie C.; Simons, Elinor; Rudders, Susan A.

doi:10.1016/j.jaip.2019.12.015

Cited by 64 publications

(46 citation statements)

References 105 publications

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“…Mistakes in the diagnosis of anaphylaxis may occur because of the limited time during which the diagnosis must be made, the stressful environment of the emergency room, the incomplete clinical features in early anaphylaxis and the lack of useful laboratory markers.Several studies have shown that anaphylaxis is often miscoded or misclassified. The frequency of miscoding appears to be similar in adults and children 9 . Updated World Allergy Organization (WAO) anaphylaxis guidelines highlighted the importance of epinephrine being the only effective treatment and that there is no role for glucocorticoids or antihistamines in severe allergic reactions 10 .…”

mentioning

confidence: 81%

Anaphylaxis in Children: Experience of an Egyptian Center

Shousha

Ezzat

Gabal

et al. 2020

Preprint

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Introduction: Anaphylaxis is a potentially life threatening allergic reaction that is rapid in onset and multisystemic in nature. Distribution of anaphylaxis tends to fluctuate based on age, gender, race, geographical residence and socioeconomic status of the involved subjects. Diagnosis of anaphylaxis in children is generally underestimated particularly in developing countries, and when diagnosed, proper management is occasionally lacking. Aim of the study: to evaluate the frequency and pattern of anaphylaxis and mistakes in diagnosis and treatment among a group of Egyptian children and adolescents. Subjects and methods: This observational study was conducted over 6 months duration, from 1st of September 2019 to the end of February 2020, in Children’s hospital, Ain Shams University, Cairo, Egypt, on children presenting to emergency department (ED). Anaphylaxis frequency, presentation, triggers, diagnosis, management and long term follow up were assessed. Results: frequency rate of anaphylaxis among children and adolescents was 0.43% (80/18816) over a year. Sixty percent of patients were infants. Biphasic reactions were reported in 11.3% of patients. The commonest trigger was food (22.5%) followed by medications (8.8%). Epinephrine was given to all patients, in proper dosage and method in most occasions (78.7%). Long term management and follow up appointment were deficient. In conclusion: Anaphylaxis in children was relatively high, with food being the most common trigger. Diagnosis and early management of anaphylaxis was satisfactory, however, long term management and follow up were defective.

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confidence: 81%

Anaphylaxis in Children: Experience of an Egyptian Center

Shousha

Ezzat

Gabal

et al. 2020

Preprint

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“…However, since anaphylaxis course is unpredictable, all cases of anaphylaxis, regardless of severity, should be treated with adrenaline, according to guidelines. 1,7 Extensive population-based studies should be conducted to confirm these results.…”

Section: Ta B L E 1 Between-clusters Comparisons Of Clinical Manifestation Of the First Episode Of Anaphylaxis In The Discovery Cohortmentioning

confidence: 98%

Cluster analysis of 505 real‐life food‐induced anaphylaxis in children reveals two stable clinical phenotypes

Błażowski

Jerzyńska

Kurzawa

et al. 2020

Allergy

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“…From a healthcare professional perspective, anaphylaxis diagnostic criteria are not sufficient to undertake a treatment decision. 21,52 Clear decision points should be established in an anaphylaxis care plan, but many differences exist. 9,13,18,20,22 Some allow for observation and hold off on epinephrine injection until additional symptoms occur or more than one organ system is involved.…”

Section: Decision Model As a Clinical Toolmentioning

confidence: 99%

“…18 These mild reactions do not require immediate epinephrine administration, as demonstrated by clinical experience and as highlighted in guidelines and care plans. 9,13,18,20 Diagnostic criteria of anaphylaxis are not ideal for identifying patients who should be treated with epinephrin.e 21 Moreover, numerous anaphylaxis guidelines and care plans differ significantly. [13][14][15][16][17]20,22 Thus, the primary assistance that guides the treatment is the symptoms severity score.…”

Section: Introductionmentioning

confidence: 99%

A severity grading system of food-induced acute allergic reactions to avoid the delay of epinephrine administration

Błażowski

Majak

Kurzawa

et al. 2021

Annals of Allergy, Asthma & Immunology

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show abstract

Epinephrine in the Management of Anaphylaxis

Cited by 64 publications

References 105 publications

Anaphylaxis in Children: Experience of an Egyptian Center

Anaphylaxis in Children: Experience of an Egyptian Center

Cluster analysis of 505 real‐life food‐induced anaphylaxis in children reveals two stable clinical phenotypes

A severity grading system of food-induced acute allergic reactions to avoid the delay of epinephrine administration

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