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Epinephrine autoinjector

N Ontiveros, E E Valdez-Meza, M J Vergara-Jiménez, A Canizalez-Román, A Borzutzky, F Cabrera-Chávez
BACKGROUND: Food allergy (FA) prevalence is well documented in developed countries and appears to be increasing, but remains unknown in most Latin American countries. We aimed to evaluate on a population basis the parent-reported prevalence of FA and its clinical characteristics in Mexican schoolchildren. METHODS: A validated Spanish version of a structured written questionnaire was administered to parents of schoolchildren aged 5-13 years old from Culiacan, Mexico...
July 27, 2016: Allergologia et Immunopathologia
Constance H Katelaris
PURPOSE OF REVIEW: The review outlines recent insights into our understanding of the complex relationships between pollen and plant food sensitization patterns resulting in the pollen fruit syndrome and the possible risk, upon ingestion, of generalized symptoms rather than localized oropharyngeal reactions. Appreciation of this risk will inform management strategies, which include epinephrine prescription. RECENT FINDINGS: In recent times, the ability to examine molecular components of foods and pollen has allowed further delineation of reactivity patterns...
August 2016: Current Opinion in Allergy and Clinical Immunology
Paul J Turner, Audrey DunnGalvin, Jonathan O'B Hourihane
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...
June 7, 2016: Journal of Allergy and Clinical Immunology in Practice
Sangil Lee, Erik P Hess, Christine Lohse, Dante Lucas S Souza, Ronna L Campbell
BACKGROUND: The prescribing pattern of epinephrine over time is an indicator of the secular trend of anaphylaxis. However, it is not well known in a population level in the United States. OBJECTIVE: To evaluate the trend of prescriptions for epinephrine autoinjectors in Olmsted County, Minn, residents. METHODS: Outpatient prescriptions for epinephrine were identified among residents of Olmsted County, Minn, between January 1, 2004, and December 31, 2010...
June 7, 2016: Journal of Allergy and Clinical Immunology in Practice
Hannah G Parish, Corinna S Bowser, Jacquelyn R Morton, Julie C Brown
BACKGROUND: Epinephrine is a lifesaving drug in the treatment of anaphylaxis and cardiac resuscitation. Current US storage recommendations are for controlled room temperature (20°C-25°C), with excursions permitted from 15°C to 30°C. Maintaining epinephrine within this required range is challenging, particularly for patients carrying autoinjectors and during storage in emergency vehicles. OBJECTIVE: To study epinephrine degradation with extreme temperature exposure for epinephrine concentrations used in anaphylaxis and cardiac resuscitation...
July 2016: Annals of Allergy, Asthma & Immunology
David J Fitzhugh, David I Bernstein
Subcutaneous allergen immunotherapy (SCIT) clearly benefits appropriately selected patients with allergic rhinitis, asthma and anaphylaxis to stinging insects. Since inception of SCIT, systemic allergic reactions (SRs) and severe anaphylaxis have been risk management challenges facing the practicing allergist. Recently it has estimated that 14% of reported SRs begin at least 30 minutes after injection administration or after the 30 minute recommended clinic observation period. Faced with the possibility that SRs could occur after the patient leaves the clinic, some practicing allergists routinely prescribe epinephrine auto-injectors to all injection patients...
September 2016: Journal of Allergy and Clinical Immunology in Practice
Robert P Olympia, Christopher Weber, Jodi Brady, Susana Ho
OBJECTIVE: The aim of the study was to determine the compliance of school transportation staff and school buses with recommendations for the safe transportation of children to and from school and school-related activities. METHODS: An electronic questionnaire was distributed to school transportation staff represented by the International Brotherhood of Teamsters during the 2013-2014 academic year. RESULTS: Analysis was performed on 558 completed questionnaires (13% usable response rate)...
May 12, 2016: Pediatric Emergency Care
Timothy Teoh, Christopher Mill, Tiffany Wong, Ingrid Baerg, Angela Alexander, Kyla J Hildebrand, John Dean, Boris Kuzeljevic, Edmond S Chan
No abstract text is available yet for this article.
May 2016: Annals of Allergy, Asthma & Immunology
Julia Sann, Supinda Bunyavanich, Julie Wang
No abstract text is available yet for this article.
September 2016: Journal of Allergy and Clinical Immunology in Practice
Patrick E Robinson, Stephanie A Lareau
Anaphylaxis is a severe, life-threatening, multisystem hypersensitivity reaction that can rapidly progress to hypotension and airway compromise. Successful management of anaphylaxis has been documented with the use of prescription intramuscular epinephrine pens that require only minimal training for safe use. The prior generations of these commercially available autoinjectors were produced for single use; however, safe removal of multiple doses has been demonstrated for use in dire situations. We aim to show a novel technique for removal and administration of additional doses of epinephrine from the new generation autoinjector, the Auvi-Q...
June 2016: Wilderness & Environmental Medicine
Margaret Redmond, Erin Kempe, Kasey Strothman, Kara Wada, Rebecca Scherzer, David R Stukus
BACKGROUND: In recent years, increased awareness of food allergy management has focused on the school setting. A lack of awareness and relevant literature prompted evaluation of the camp experience. OBJECTIVES: To characterize the prevalence of food allergies among children attending an overnight summer camp and to evaluate the knowledge and comfort of camp personnel before and after a training session. METHODS: The database for the 2014 season at Flying Horse Farms was reviewed for information pertaining to food allergies and provision of epinephrine and treatment plans...
April 2, 2016: Annals of Allergy, Asthma & Immunology
Artemio M Jongco, Sheila Bina, Robert J Sporter, Marie A Cavuoto Petrizzo, Blanka Kaplan, Myriam Kline, Susan J Schuval
Physicians underrecognize and undertreat anaphylaxis. Effective interventions are needed to improve physician knowledge and competency regarding evidence-based anaphylaxis diagnosis and management (ADAM). We designed and evaluated an educational program to improve ADAM in pediatrics, internal medicine, and emergency medicine residents from two academic medical centers. Anonymous questionnaires queried participants' demographics, prior ADAM clinical experience, competency, and comfort. A pretest assessing baseline knowledge preceded a 45-minute allergist-led evidence-based presentation, including practice with epinephrine autoinjectors, immediately followed by a posttest...
2016: Journal of Allergy
Karen S Farbman, Kenneth A Michelson
PURPOSE OF REVIEW: Anaphylaxis is a serious allergic reaction that can be life threatening. We will review the most recent evidence regarding the diagnosis, treatment, monitoring, and prevention of anaphylaxis in children. RECENT FINDINGS: Histamine and tryptase are not sufficiently accurate for the routine diagnosis of anaphylaxis, so providers should continue to rely on clinical signs. Platelet-activating factor shows some promise in the diagnosis of anaphylaxis...
June 2016: Current Opinion in Pediatrics
Linus B Grabenhenrich, Sabine Dölle, Anne Moneret-Vautrin, Alice Köhli, Lars Lange, Thomas Spindler, Franziska Ruëff, Katja Nemat, Ioana Maris, Eirini Roumpedaki, Kathrin Scherer, Hagen Ott, Thomas Reese, Tihomir Mustakov, Roland Lang, Montserrat Fernandez-Rivas, Marek L Kowalski, Maria B Bilò, Jonathan O'B Hourihane, Nikolaos G Papadopoulos, Kirsten Beyer, Antonella Muraro, Margitta Worm
BACKGROUND: Anaphylaxis in children and adolescents is a potentially life-threatening condition. Its heterogeneous clinical presentation and sudden occurrence in virtually any setting without warning have impeded a comprehensive description. OBJECTIVE: We sought to characterize severe allergic reactions in terms of elicitors, symptoms, emergency treatment, and long-term management in European children and adolescents. METHODS: The European Anaphylaxis Registry recorded details of anaphylaxis after referral for in-depth diagnosis and counseling to 1 of 90 tertiary allergy centers in 10 European countries, aiming to oversample the most severe reactions...
April 2016: Journal of Allergy and Clinical Immunology
Julie C Brown, Rachel E Tuuri, Sabreen Akhter, Lilia D Guerra, Ian S Goodman, Sage R Myers, Charles Nozicka, Shannon Manzi, Katharine Long, Troy Turner, Gregory P Conners, Rachel W Thompson, Esther Park
STUDY OBJECTIVE: Epinephrine autoinjector use for anaphylaxis is increasing. There are reports of digit injections because of incorrect autoinjector use, but no previous reports of lacerations, to our knowledge. We report complications of epinephrine autoinjector use in children and discuss features of these devices, and their instructions for use, and how these may contribute to injuries. METHODS: We queried emergency medicine e-mail discussion lists and social media allergy groups to identify epinephrine autoinjector injuries involving children...
March 2016: Annals of Emergency Medicine
Ashley A Foster, Ronna L Campbell, Sangil Lee, Jana L Anderson
Introduction. Children with severe food allergies may spend many hours in the preschool setting. Little is known about anaphylaxis recognition and management preparedness among preschool staff. The objective of this study was to assess anaphylaxis preparedness among preschool staff. Methods. Anonymous questionnaires were administered before and after a 40-minute educational seminar on anaphylaxis recognition and management. Results. In total, 181 individuals participated in the preintervention survey and 171 participated in the postintervention survey...
2015: Journal of Allergy
Michelle Halbrich, Douglas P Mack, Stuart Carr, Wade Watson, Harold Kim
Epinephrine (adrenaline) is the treatment of choice for anaphylaxis. While other medications, including H1-antihistamines, H2-antihistamines, corticosteroids, and inhaled beta-2 agonists are often used to treat anaphylaxis in the emergency setting, none of these medications has been shown to reverse anaphylaxis. Fatal anaphylaxis is related to the delayed use of epinephrine. In community settings, epinephrine is available as an auto-injector in two doses, 0.15 mg and 0.3 mg. The recommended dose for children is 0...
2015: Allergy, Asthma, and Clinical Immunology
Heather Beasley, Pearlly Ng, Albert Wheeler, William R Smith, Scott E McIntosh
OBJECTIVES: Epinephrine is the first-line medical treatment for anaphylaxis, a life-threatening allergic syndrome. To treat anaphylaxis, backcountry recreationalists and guides commonly carry epinephrine autoinjectors. Epinephrine may be exposed to cold temperatures and freezing during expeditions. An epinephrine solution must contain 90% to 115% of the labeled epinephrine amount to meet United States Pharmacopeia standards. The purpose of this study was to determine whether freeze-thaw cycles alter epinephrine concentrations in autoinjectors labeled to contain 1...
December 2015: Wilderness & Environmental Medicine
J L P Protudjer, S-A Jansson, E Östblom, M Heibert Arnlind, U Bengtsson, S-E Dahlén, I Kallström-Bengtsson, B Marklund, R J M Middelveld, G Rentzos, A C Sundqvist, J Åkerström, S Ahlstedt
AIM: Among Swedish children of 0-12 years old, we investigated various food allergy-related exposures associated with health-related quality of life using a food allergy-specific questionnaire among children allergic to the staple foods cow's milk, hen's egg and/or wheat, and contextualised worse food allergy-associated health-related quality of life using a generic questionnaire versus controls. METHODS: In total, 85 children with objectively diagnosed allergy to the staple foods were included as cases, and 94 children matched for age and sex were included as controls...
October 2015: Acta Paediatrica
Ulrich R Müller, Johannes Ring
BACKGROUND: Stings by Hymenoptera (honey bees, vespids, ants) can cause systemic allergic reactions (SARs). Venom immunotherapy (VIT) is highly effective and reduces an allergic patient's risk of a recurrent SAR to less than 5-20%. The risk of a recurrent SAR to a re-sting decreases the longer VIT is continued. The recommended duration of VIT is at least 3 to 5 years. RISK FACTORS: Risk factors for recurrent SARs to a sting after stopping VIT have been identified and discussed: Recommendations concerning stopping VIT: For patients without any of the identified risk factors, VIT should be continued for 5 rather than 3 years...
May 2015: Journal of Allergy and Clinical Immunology in Practice
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