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Epinephrine autoinjector

Jarkko Mäntylä, Tuuli Thomander, Auli Hakulinen, Kaarina Kukkonen, Kati Palosuo, Helena Voutilainen, Anna Pelkonen, Paula Kauppi
INTRODUCTION: The standard care of severe food allergy in both adults and children means avoidance of allergens. In recent years promising results of oral immunotherapy (OIT) have been reported in children. In adults, information on OIT in severe food allergy is very limited. OBJECTIVE: We aimed to study if OIT is possible in adults. METHODS: We report OIT results in 10 adult patients with milk OIT, nine adult patients with peanut OIT, and four adult patients with egg OIT...
March 15, 2018: Immunity, Inflammation and Disease
Jessica L Peck, E Katherine Larson, Stacy K Silvers
The prevalence of food allergy has risen dramatically in the last two decades. Primary care providers encounter food-allergic children on a daily basis. Although the standard of care has traditionally been strict avoidance of the allergen and advisement to carry an epinephrine autoinjector in case of an accidental exposure resulting in a severe reaction, food allergy research has progressed in the past decade concerning various immunotherapies that may provide an alternate treatment strategy. Oral immunotherapy (OIT), performed under the supervision of an allergist, is the most widely studied of these therapies...
March 12, 2018: Journal of Pediatric Health Care
Sten Dreborg, Laura Kim, Gina Tsai, Harold Kim
BACKGROUND: Administration of epinephrine should be intramuscularly in the anterolateral aspect of the thigh. The length of the epinephrine autoinjector, EAI, needle should assure intramuscular injection. OBJECTIVE: To discuss suitable needle lengths of EAIs based on ultrasound measurements related to weight. METHODS: The skin to muscle distance (STMD) and skin to bone distance (STBD) was measured by ultrasound on the mid third anterolateral area of the right thigh, applying either high pressure (max)(8 lb...
February 27, 2018: Annals of Allergy, Asthma & Immunology
Ronald B Moss, Karen Daniels, Thomas Moll, Dennis J Carlo
No abstract text is available yet for this article.
February 27, 2018: Annals of Allergy, Asthma & Immunology
Marcus Shaker, Tsuzumi Kanaoka, Robert Gp Murray, Dana Toy, Susan Shaker, Aurora Drew
No abstract text is available yet for this article.
February 27, 2018: Journal of Allergy and Clinical Immunology in Practice
H Thomson, R Seith, S Craig
BACKGROUND: Pediatric anaphylaxis is commonly misdiagnosed in the Emergency Department (ED). We aimed to determine the impact of inaccurate diagnosis on the management and follow-up of pediatric anaphylaxis presenting to the ED. METHODS: Retrospective chart review of ED management of children aged 0-18 years with allergic presentations to three EDs in Melbourne, Australia in 2014. Cases were included if an ED diagnosis of anaphylaxis was recorded, or the presentation met international consensus criteria for anaphylaxis...
February 7, 2018: BMC Pediatrics
Emily Andrew, Ziad Nehme, Stephen Bernard, Karen Smith
OBJECTIVE: Although hospital presentations for pediatric anaphylaxis have been described in the literature, a minimal amount is known regarding the incidence, characteristics, and management of pediatric anaphylaxis presenting to emergency medical services (EMS). METHODS: We performed a retrospective observational study of pediatrics (≤16 years) presenting to EMS in Victoria, Australia. Patients with suspected anaphylaxis were included if they were treated with epinephrine before or after EMS arrival...
January 19, 2018: Prehospital Emergency Care
Andrew J Latimer, Sofia Husain, Jonathan Nolan, Vinod Doreswamy, Thomas D Rea, Michael R Sayre, Mickey S Eisenberg
OBJECTIVE: In recent years, the costs of epinephrine autoinjectors (EAIs) in the United States have risen substantially. King County Emergency Medical Services implemented the "Check and Inject" program to replace EAIs by teaching emergency medical technicians (EMTs) to manually aspirate epinephrine from a single-use 1 mg/mL epinephrine vial using a needle and syringe followed by prehospital intramuscular administration of the correct adult or pediatric dose of epinephrine for anaphylaxis or serious allergic reaction...
January 15, 2018: Prehospital Emergency Care
Emily Frances Reid, Mamidupudi Thirumala Krishna, Claire Bethune
AIM: To record the level of allergy teaching occurring in UK medical schools. The UK has experienced an 'allergy epidemic' during the last 3-4 decades. Previous government reviews have emphasised the importance of allergy education and training, treating common allergies in primary care with referral pathways to a specialist and the creation of regional networks. It is acknowledged that the delivery of allergy teaching in UK medical schools is variable, despite the well-recognised need...
January 5, 2018: Journal of Clinical Pathology
Maria Luiza Kraft Köhler Ribeiro, Herberto José Chong Neto, Nelson Augusto Rosario Filho
Anaphylaxis is a severe, life-threatening generalized or systemic hypersensitivity reaction that requires rapid and adequate care. This study aimed to obtain an integrated view of the level of physicians' knowledge related with treatment of anaphylaxis in studies published within the last 5 years. Sixteen studies were found and four points were identified as of the great interest to the authors: (1) emergency pharmacological treatment, (2) epinephrine auto-injectors prescription, (3) knowledge of the main signs of anaphylaxis, and (4) admission of the patient to verify biphasic reactions...
October 2017: Einstein
Matthew Grissinger
Epinephrine for anaphylaxis: Autoinjector or 1-mg vial or ampoule?
December 2017: P & T: a Peer-reviewed Journal for Formulary Management
Tobias Fritz, Tim Pohlemann, Moritz Klein
No abstract text is available yet for this article.
November 24, 2017: Deutsches Ärzteblatt International
Martha V White
BACKGROUND: Without securing a child properly, injuries can happen with the use of pediatric epinephrine autoinjectors (EAI), and lacerations and embedded needles have been reported. Health care providers should ensure that instruction is provided to parents on how to hold a child during an injection with an EAI. OBJECTIVE: To demonstrate the compassionate restraint of small children during an allergic emergency to ensure the safe use of an EAI. METHODS: A patient was used to illustrate a compassionate restraint technique during a mock injection with an EAI...
March 29, 2018: Allergy and Asthma Proceedings:
Elissa M Abrams, Alexander G Singer, Lisa Lix, Alan Katz, Marina Yogendran, F Estelle R Simons
Background: The aim of this study was to estimate primary adherence for epinephrine autoinjector (EA) prescriptions in primary care practices in Manitoba, Canada. Methods: A retrospective analysis of electronic medical record and administrative data was performed to determine primary adherence, defined as dispensation of a new EA prescription within 90 days of the date the prescription was written. Multivariable logistic regression models were used to test predictors of filling an EA prescription...
2017: Allergy, Asthma, and Clinical Immunology
Elizabeth Feuille, Cheryl Lawrence, Caroline Volel, Scott H Sicherer, Julie Wang
OBJECTIVES: To assess time trends in food allergy diagnoses, epinephrine autoinjector (EAI) prescriptions, and EAI administrations in the school setting. STUDY DESIGN: In this retrospective study, deidentified student data from the New York City Department of Health and Mental Hygiene, which oversees >1 million students in 1800 schools, were provided to investigators. Data from school years 2007-2008 to 2012-2013 pertaining to diagnoses of food allergy, student-specific EAI orders, and EAI administrations among students in New York City were analyzed for trends over time, via the use of ORs and χ2 calculation...
November 2017: Journal of Pediatrics
Mark R Peterson, Christopher A Coop
Reported is a case of a 39-year-old male who was diagnosed with exercise-induced anaphylaxis (EIA). He was initially treated prophylactically with fexofenadine, montelukast, and ranitidine. He also used an epinephrine autoinjector as needed. He was refractory to these medications and continued to have episodes of EIA. He was then started on a trial of omalizumab, an immunoglobulin E monoclonal antibody, and had resolution of the EIA episodes. After discontinuation of the omalizumab, the EIA episodes returned...
October 1, 2017: Allergy & Rhinology
Paul A Greenberger, Dana V Wallace, Phillip L Lieberman, Sean M Gregory
BACKGROUND: Food allergy and anaphylaxis appear to be increasing in the United States, especially in young children, and preparedness is paramount to successful emergency management in the community. Although the treatment of choice for anaphylaxis is epinephrine delivered by autoinjection, some devices are challenged by less user-friendly designs or pose the risk of injury, especially in young patients. Human factors engineering has played a larger role in the development of more recent epinephrine autoinjector technologies and will continue to play a role in the evolution and future design of epinephrine autoinjectors...
October 2017: Annals of Allergy, Asthma & Immunology
Susan Waserman, Ernie Avilla, Moshe Ben-Shoshan, Lana Rosenfield, Andrea Burke Adcock, Matthew Greenhawt
Epinephrine is the first-line treatment for anaphylaxis. Despite this, there have been identified gaps in the management of anaphylaxis including infrequent or delayed use of epinephrine for acute allergic reactions, as well as inadequate epinephrine autoinjector (EAI) training, and prescription rates of these devices for patients at risk. This paper reviews new data, and new problems in recently published literature on EAIs. A database search was conducted for publications between January 2015 and February 2017 using keywords related to EAIs including their functionality and features, carriage, prescription rates, barriers, and side effects...
September 2017: Journal of Allergy and Clinical Immunology in Practice
Herman Tam, F Estelle R Simons, Elinor Simons
No abstract text is available yet for this article.
September 2017: Journal of Allergy and Clinical Immunology in Practice
Megan S Motosue, M Fernanda Bellolio, Holly K Van Houten, Nilay D Shah, Venkatesh R Bellamkonda, David M Nestler, Ronna L Campbell
BACKGROUND: Anaphylaxis is a potentially life-threatening allergic reaction; measures including prescription of an epinephrine autoinjector (EAI) and allergy/immunology (A/I) follow-up may prevent future morbidity. OBJECTIVE: The objective of this study was to evaluate trends in outpatient management of anaphylaxis by studying EAI dispensing and A/I follow-up among patients seen in the emergency department (ED) for anaphylaxis from 2005 through 2014. METHODS: We analyzed administrative claims data from the OptumLabs Data Warehouse database using an expanded International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code algorithm...
September 2017: Journal of Allergy and Clinical Immunology in Practice
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