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epinephrine in anaphylaxis

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https://www.readbyqxmd.com/read/29656144/short-and-long-term-management-of-cases-of-venom-induced-anaphylaxis-via-is-suboptimal
#1
Ashley Tritt, Sofianne Gabrielli, Sarah Zahabi, Ann Clarke, Jocelyn Moisan, Harley Eisman, Judy Morris, Lea Restivo, Greg Shand, Moshe Ben-Shoshan
BACKGROUND: Venom induced anaphylaxis (VIA) accounts for severe reactions. However, little is known about the short and long-term management of VIA cases. OBJECTIVE: To assess the short and long-term management of VIA. METHODS: Using a national anaphylaxis registry (C-CARE), we identified VIA cases presenting to EDs in Montreal and to emergency medical services(EMS) in Western Quebec over a four-year period. Data were collected on clinical characteristics, triggers, and management...
April 12, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29621018/management-of-anaphylaxis-in-spain-pediatric-emergency-care-providers-knowledge
#2
Mikel Olabarri, Sebastiá Gonzalez-Peris, Paula Vázquez, Aranzazu González-Posada, Nuria Sanz, Ana Vinuesa, Nuria Diez, Javier Benito, Santiago Mintegi
BACKGROUND: Acute care providers must diagnose and treat patients with anaphylaxis. The objective was to analyze Spanish pediatric emergency departments' (ED) providers' knowledge of the international recommendations for the management of anaphylaxis. METHODS: A web-based survey including providers (both attending and residents) from seven Spanish pediatric EDs was conducted. To analyze the knowledge of the identification of anaphylaxis, we used the diagnostic criteria given by the National Institute of Allergy and Infectious Disease and Food Allergy and the Food Allergy and Anaphylaxis Network (2005)...
April 4, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29615480/improving-anaphylaxis-care-the-impact-of-a-clinical-pathway
#3
Juhee Lee, Bonnie Rodio, Jane Lavelle, Megan Ott Lewis, Rachel English, Sarah Hadley, Jennifer Molnar, Cynthia Jacobstein, Antonella Cianferoni, Jonathan Spergel, Lisa Zielinski, Nicholas Tsarouhas, Terri Brown-Whitehorn
BACKGROUND: Recommended durations of observation after anaphylaxis have been widely variable, with many ranging from 4 to 24 hours. Prolonged durations often prompt admission for ongoing observation. METHODS: In a multidisciplinary quality improvement initiative, we revised our emergency department (ED) anaphylaxis clinical pathway. Our primary aim was to safely decrease the recommended length of observation from 8 to 4 hours and thereby decrease unnecessary hospitalizations...
April 3, 2018: Pediatrics
https://www.readbyqxmd.com/read/29609214/barriers-to-the-administration-of-epinephrine-in-schools
#4
Susan L Hogue, Rafael Muniz, Christopher Herrem, Suyapa Silvia, Martha V White
BACKGROUND: Anaphylaxis is a serious and growing concern in the school setting as the prevalence of food allergies and food-induced severe allergic reactions continues to increase. METHODS: A cross-sectional, web-based survey was conducted regarding anaphylactic events that occurred during the 2014-2015 school year. Eligible schools were enrolled in the EPIPEN4SCHOOLS® program (Mylan Specialty L.P., Canonsburg, PA), which provides free epinephrine auto-injectors to qualifying US schools...
May 2018: Journal of School Health
https://www.readbyqxmd.com/read/29606638/epinephrine-in-severe-allergic-reactions-the-european-anaphylaxis-register
#5
Linus B Grabenhenrich, Sabine Dölle, Franziska Ruëff, Jean-Marie Renaudin, Kathrin Scherer, Claudia Pföhler, Regina Treudler, Alice Koehli, Vera Mahler, Thomas Spindler, Lars Lange, Maria Beatrice Bilò, Nikolaos G Papadopoulos, Jonathan O B Hourihane, Roland Lang, Montserrat Fernández-Rivas, George Christoff, Ewa Cichocka-Jarosz, Margitta Worm
BACKGROUND: Current guidelines recommend intramuscular administration of epinephrine as the first-line drug for the emergency treatment of severe allergic reactions (anaphylaxis), but no randomized trial evidence supports this consensus. OBJECTIVE: We aimed to assess anaphylaxis treatment practices over 10 years, covering several European regions, all allergen sources, and all age groups. METHODS: The European Anaphylaxis Register tracks elicitors, symptoms, emergency treatment, diagnostic workups, and long-term counseling for anaphylaxis incidents through web-based data entry from tertiary allergy specialists, covering information from the emergency respondent, patient, tertiary referral, and laboratory/clinical test results...
March 29, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29601357/application-of-precision-medicine-to-the-treatment-of-anaphylaxis
#6
Marina Labella, Marlene Garcia-Neuer, Mariana Castells
PURPOSE OF REVIEW: Recognize the presentation of anaphylaxis for prompt management and treatment and to provide tools for the diagnosis of the underlying cause(s) and set up a long-term treatment to prevent recurrence of anaphylaxis. RECENT FINDINGS: The recent description of phenotypes provides new insight and understanding into the mechanisms and causes of anaphylaxis through a better understanding of endotypes and biomarkers for broad clinical use. SUMMARY: Anaphylaxis is the most severe hypersensitivity reaction and can lead to death...
March 29, 2018: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29561357/how-to-manage-food-allergy-in-nursery-or-school
#7
Roxanne C Oriel, Julie Wang
PURPOSE OF REVIEW: The aim of this review is to describe effective management strategies in nursery or school based upon research findings. RECENT FINDINGS: The prevalence of food allergy and number of emergency department visits for food-related anaphylaxis are increasing in children and adolescents. As there is currently no cure, the most effective strategy to decrease allergic reactions is food allergen avoidance. However, allergic reactions are inevitable in both food allergic children as well as in first-time reactors...
March 20, 2018: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29542298/immediate-hypersensitivity-reactions-induced-by-triamcinolone-in-a-patient-with-atopic-dermatitis
#8
Jee Hee Son, Sook Young Park, Yong Se Cho, Bo Young Chung, Hye One Kim, Chun Wook Park
Corticosteroids are potent anti-inflammatory and anti-allergic agents used in the treatment of various inflammatory diseases, including allergic disease. They are frequently considered the therapy-of-choice for many skin diseases. However, allergic reactions caused by corticosteroids have been reported. Among these, delayed reactions to topical steroids are more common, whereas immediate reactions to systemic steroids are rare. Herein, we report the case of a 32-year-old woman with triamcinolone-induced immediate hypersensitivity reaction, in which the patient had a positive prick test result with triamcinolone...
March 19, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29508717/school-nurse-perspectives-on-school-policies-for-food-allergy-and-anaphylaxis
#9
Lauren M Kao, Julie Wang, Olga Kagan, Anne Russell, S Shahzad Mustafa, Diane Houdek, Bridget Smith, Ruchi Gupta
BACKGROUND: Although school health care professionals are integral to the management of students with food allergy, their views on school food allergy policies have not yet been reported. OBJECTIVE: To characterize food allergy policies currently being used in schools and their utility and potential barriers to implementation from the perspective of school health care professionals. METHODS: An electronic survey was disseminated to school nurses at the 2016 National Association of School Nurses meeting and through the Allergy and Asthma Network listserv...
March 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29505006/clinically-suspected-anaphylaxis-induced-by-sugammadex-in-a-patient-with-weaver-syndrome-undergoing-restrictive-mammoplasty-surgery-a-case-report-with-the-literature-review
#10
REVIEW
Nurdan Bedirli, Berrin Işık, Mehrnoosh Bashiri, Kutluk Pampal, Ömer Kurtipek
RATIONALE: Sugammadex is a cylodextrin derivate that encapsulates steroidal neuromuscular blocker agents and is reported as a safe and well-tolerated drug. In this case report, we present a patient who developed grade 3 anaphylaxis just after sugammadex administration. PATIENT CONCERNS: A 22-year-old woman with diagnosis of Weaver syndrome was scheduled for bilateral mammoplasty and resection of unilateral accessory breast tissue resection. Anesthesia was induced and maintained by propofol, rocuronium, and remifentanil...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29501378/is-surgical-antibiotic-prophylaxis-necessary-for-pediatric-orchiopexy
#11
A J Rensing, B M Whittam, K H Chan, M P Cain, A E Carroll, W E Bennett
INTRODUCTION: Surgeons frequently use surgical antibiotic prophylaxis (SAP), despite limited evidence to support its efficacy. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), Clostridium difficile infection, and selecting for resistant bacteria. Surgical site infections (SSI) are very rare in patients undergoing clean pediatric urologic procedures. Current guidelines are unclear about the efficacy of surgical antibiotic prophylaxis for prevention of SSI in the pediatric population...
February 21, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29477569/a-multicenter-evaluation-of-diagnosis-and-management-of-omega-5-gliadin-allergy-also-known-as-wheat-dependent-exercise-induced-anaphylaxis-in-132-adults
#12
Lucinda Kennard, Iason Thomas, Krzysztof Rutkowski, Vian Azzu, Patrick Fk Yong, Bogusia Kasternow, Hannah Hunter, Naeema Mo Cabdi, Alla Nakonechna, Annette Wagner
BACKGROUND: Omega-5 gliadin allergy (also known as wheat-dependent exercise induced anaphylaxis) is a rare allergy to wheat which often presents with intermittent severe anaphylaxis in the context of a co-factor, such as exercise. OBJECTIVES: To undertake a detailed clinical characterisation of the largest cohort of omega 5-gliadin allergic patients to date. METHODS: We retrospectively analysed the demographics, presentation, investigation and management of 132 patients presenting to 4 UK centres with omega-5 gliadin allergy...
February 22, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29449164/patients-taking-%C3%AE-blockers-do-not-require-increased-doses-of-epinephrine-for-anaphylaxis
#13
Jennifer L White, Katie C Greger, Sangil Lee, Robert J Kahoud, James T Li, Christine M Lohse, Ronna L Campbell
BACKGROUND: β-Blocker use has been associated with increased anaphylaxis severity. OBJECTIVE: We aimed to assess for an association between β-blocker use and requirement for more than 1 dose of epinephrine for anaphylaxis management. METHODS: We conducted a retrospective observational study of patients seen in our emergency department for anaphylaxis between April 2008 and January 2015. The primary outcome measure was the number of doses of epinephrine...
February 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29439456/epinephrine-in-anaphylaxis-preclinical-study-of-pharmacokinetics-after-sublingual-administration-of-taste-masked-tablets-for-potential-pediatric-use
#14
Ousama Rachid, Mutasem Rawas-Qalaji, Keith J Simons
Epinephrine is a life-saving treatment in anaphylaxis. In community settings, a first-aid dose of epinephrine is injected from an auto-injector (EAI). Needle phobia highly contributes to EAI underuse, leading to fatalities-especially in children. A novel rapidly-disintegrating sublingual tablet (RDST) of epinephrine was developed in our laboratory as a potential alternative dosage form. The aim of this study was to evaluate the sublingual bioavailability of epinephrine 30 mg as a potential pediatric dose incorporated in our novel taste-masked RDST in comparison with intramuscular (IM) epinephrine 0...
February 11, 2018: Pharmaceutics
https://www.readbyqxmd.com/read/29415679/downstream-consequences-of-diagnostic-error-in-pediatric-anaphylaxis
#15
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
https://www.readbyqxmd.com/read/29411554/are-registration-of-disease-codes-for-adult-anaphylaxis-accurate-in-the-emergency-department
#16
Byungho Choi, Sun Hyu Kim, Hyeji Lee
PURPOSE: There has been active research on anaphylaxis, but many study subjects are limited to patients registered with anaphylaxis codes. However, anaphylaxis codes tend to be underused. The aim of this study was to investigate the accuracy of anaphylaxis code registration and the clinical characteristics of accurate and inaccurate anaphylaxis registration in anaphylactic patients. METHODS: This retrospective study evaluated the medical records of adult patients who visited the university hospital emergency department between 2012 and 2016...
March 2018: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/29408441/value-of-a-second-dose-of-epinephrine-during-anaphylaxis-a-patient-caregiver-survey
#17
T Ted Song, Duncan Brown, Martin Karjalainen, Ulrike Lehnigk, Phil Lieberman
BACKGROUND: Anaphylaxis guidelines recommend prescription of >1 epinephrine auto-injector (EAI) for patients at risk. A second epinephrine dose is required in 16 to 36% of patients. OBJECTIVE: Evaluate real-world use of EAIs and understand the patients/caregivers' adherence to guidelines. METHODS: We collected survey responses from United States patients and caregivers with an EAI prescription in November 2015. The survey covered several domains relevant to anaphylaxis and EAI use...
February 2, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29407420/changes-in-emergency-department-concordance-with-guidelines-for-the-management-of-stinging-insect-induced-anaphylaxis-1999-2001-versus-2013-2015
#18
Sunday Clark, Krislyn M Boggs, Diana S Balekian, Kohei Hasegawa, Phuong Vo, Brian H Rowe, Carlos A Camargo
BACKGROUND: Changes in emergency department (ED) concordance with guidelines for the management of stinging insect-induced anaphylaxis (SIIA) are not known. OBJECTIVE: We describe temporal changes in ED concordance with guidelines for the management of SIIAs. METHODS: We analyzed data from two multicenter retrospective studies of patients with stinging insect-related acute allergic reactions seen in one of 14 North American EDs during two time periods: 1999-2001 and 2013-2015...
January 30, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29406471/life-threatening-accidental-intravenous-epinephrine-overdose-in-a-12-year-old-boy
#19
Maya Caroline André, Jürg Hammer
Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with a long-lasting skin rash and dyspnea who was incorrectly diagnosed with early anaphylactic shock and was treated with 10-fold the recommended dose administered by the wrong route (intravenous instead of intramuscular). He reacted with acute loss of consciousness and acute cardiorespiratory failure due to arterial hypotension, ischemic heart failure, and severe pulmonary edema...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29364730/improving-prehospital-protocol-adherence-using-bundled-educational-interventions
#20
Megan C Marino, Daniel G Ostermayer, Juan A Mondragon, Elizabeth A Camp, Elizabeth M Keating, Louis B Fornage, Charles A Brown, Manish I Shah
BACKGROUND: Seizures and anaphylaxis are life-threatening conditions that require immediate treatment in the prehospital setting. There is variation in treatment of pediatric prehospital patients for both anaphylaxis and seizures. This educational study was done to improve compliance with pediatric prehospital protocols, educate prehospital providers and decrease variation in care. OBJECTIVE: To improve the quality of care for children with seizures and anaphylaxis in the prehospital setting using a bundled, multifaceted educational intervention...
January 24, 2018: Prehospital Emergency Care
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