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epinephrine in anaphylaxis

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https://www.readbyqxmd.com/read/28193793/guidance-on-completing-a-written-allergy-and-anaphylaxis-emergency-plan
#1
Julie Wang, Scott H Sicherer
Anaphylaxis is a potentially life-threatening, severe allergic reaction. The immediate assessment of patients having an allergic reaction and prompt administration of epinephrine, if criteria for anaphylaxis are met, promote optimal outcomes. National and international guidelines for the management of anaphylaxis, including those for management of allergic reactions at school, as well as several clinical reports from the American Academy of Pediatrics, recommend the provision of written emergency action plans to those at risk of anaphylaxis, in addition to the prescription of epinephrine autoinjectors...
February 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/28193791/epinephrine-for-first-aid-management-of-anaphylaxis
#2
Scott H Sicherer, F Estelle R Simons
Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community...
February 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/28117270/food-allergic-adolescents-at-risk-for-anaphylaxis-a-randomized-controlled-study-of-supervised-injection-to-improve-comfort-with-epinephrine-self-injection
#3
Eyal Shemesh, Christine D'Urso, Christopher Knight, Melissa Rubes, Kinga M Picerno, Ailie M Posillico, Zara Atal, Rachel A Annunziato, Scott H Sicherer
BACKGROUND: Epinephrine self-injection is a key element in the management of food allergy, yet many adolescents report that they may not be able to use the autoinjector when needed. We hypothesized that supervised self-injection with an empty syringe would increase adolescents' comfort with self-injection. OBJECTIVE: The objective of this study was to examine the effect of supervised self-injection on self- and parent-reported comfort and anxiety during and after clinic visits in a food allergy center...
January 20, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28115856/anaphylaxis-across-two-canadian-pediatric-centers-evaluating-management-disparities
#4
Alison Ym Lee, Paul Enarson, Ann E Clarke, Sébastien La Vieille, Harley Eisman, Edmond S Chan, Christopher Mill, Lawrence Joseph, Moshe Ben-Shoshan
BACKGROUND: There are no data on the percentage of visits due to anaphylaxis in the emergency department (ED), triggers, and management of anaphylaxis across different provinces in Canada. OBJECTIVE: To compare the percentage of anaphylaxis cases among all ED visits, as well as the triggers and management of anaphylaxis between two Canadian pediatric EDs (PEDs). METHODS: As part of the Cross-Canada Anaphylaxis Registry (C-CARE), children presenting to the British Columbia Children's Hospital (BCCH) and Montreal Children's Hospital (MCH) EDs with anaphylaxis were recruited...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28069483/epinephrine-use-in-older-patients-with-anaphylaxis-clinical-outcomes-and-cardiovascular-complications
#5
Takahisa Kawano, Frank Xavier Scheuermeyer, Robert Stenstrom, Brian H Rowe, Eric Grafstein, Brian Grunau
BACKGROUND: There is little data describing the differences in epinephrine (epi) administration and cardiac complications among older and younger patients with anaphylaxis. METHODS: This retrospective cohort study was conducted at two urban emergency departments (ED) over a 5 year-period, and included adults who met a pre-specified criteria for anaphylaxis. Patients ≥50years of age were defined as "older". Univariate logistic regression was performed to compare the difference in frequency of epi administration between the "older" and "younger" groups...
January 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28052801/factors-that-determine-parents-perception-of-their-child-s-risk-of-life-threatening-food-induced-anaphylaxis
#6
Jennifer Ogg, Jayne Wong, Ming Wai Wan, Naomi Davis, Peter D Arkwright
BACKGROUND: Although food allergy is known to be associated with increased disease burden, factors that shape parents' perception of their child's risk of future severe or fatal anaphylaxis are poorly understood. OBJECTIVE: This study aimed to evaluate factors associated with parents' perceived risk of food-induced anaphylaxis. METHODS: A questionnaire-based survey of 202 parents was conducted in a single specialist center outpatient clinic that treats children with food allergies...
January 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27999602/anaphylaxis-to-supplemental-oral-lactase-enzyme
#7
M R Voisin, R Borici-Mazi
BACKGROUND: Anaphylactic reactions involving IgE mediated hypersensitivity have been frequently reported for a number of uncommon foods. However, cases of anaphylaxis to over the counter vitamins and oral supplements have been rarely published. Lactose intolerance affects approximately 20% of Canadians and roughly 70% of the world's population of any age. Lactose intolerance develops primarily due to the absence of the enzyme lactase and treatment involves avoidance of lactose-containing foods or ingestion of commercially available lactase enzyme preparations prior to their consumption...
2016: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/27992679/incomplete-and-incorrect-epinephrine-auto-injector-training-to-food-allergic-patients-by-pharmacists-in-the-netherlands
#8
J Saleh-Langenberg, S de Vries, E Bak, B J Kollen, B M J Flokstra-de Blok, A E J Dubois
BACKGROUND: Successful treatment of anaphylaxis in the community relies on early and correct use of epinephrine auto-injectors (EAI). In the Netherlands pharmacists supply EAIs to patients and have a crucial role in instructing patients in how and when to use EAI. However, there are currently no data in Europe on the quality of such instruction provided by pharmacists. Therefore, the aims of this study were to investigate the knowledge, attitudes, and beliefs regarding food allergy among pharmacists in the Netherlands, and to investigate the quality of EAI instructions and demonstrations to patients by pharmacists...
December 19, 2016: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/27984266/unintentional-epinephrine-auto-injector-injuries-a-national-poison-center-observational-study
#9
Marco Anshien, S Rutherfoord Rose, Brandon K Wills
BACKGROUND: Epinephrine is the only first-line therapeutic agent used to treat life-threatening anaphylaxis. Epinephrine auto-injectors are commonly carried by patients at risk for anaphylaxis, and reported cases of unintentional auto-injector injury have increased over the last decade. Modifications of existing designs and release of a new style of auto-injector are intended to reduce epinephrine auto-injector misuse. STUDY QUESTION: The aim of the study was to characterize reported cases of unintentional epinephrine auto-injector exposures from 2013 to 2014 and compare demographics, auto-injector model, and anatomical site of such exposures...
November 24, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/27979023/rate-of-recurrent-anaphylaxis-and-associated-risk-factors-among-olmsted-county-minnesota-residents-a-population-based-study
#10
Sangil Lee, Curtis Bashore, Christine M Lohse, M Fernanda Bellolio, Alanna Chamberlain, Kumi Yuki, Erik P Hess, Ronna L Campbell
BACKGROUND: The rate and risk factors for recurrence of anaphylaxis are not well known. OBJECTIVE: To measure the rate and risk factors for recurrent anaphylaxis in a population-based cohort in Olmsted County, Minnesota. METHODS: We conducted a population-based cohort study using the Rochester Epidemiology Project, a comprehensive medical records linkage system, to obtain records of patients who presented to medical centers within the Olmsted County area with anaphylaxis from January 1, 2001, through December 31, 2010...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27957774/pediatric-anaphylaxis-in-the-operating-room-for-anesthesia-residents-a-simulation-study
#11
Emily B Johnston, Collin King, Peter A Sloane, Jerral W Cox, Amber Q Youngblood, Jerry Lynn Zinkan, Nancy M Tofil
BACKGROUND: Pediatric intraoperative emergencies are rare but it is crucial for an anesthesia resident to be proficient in their management. Even the more common emergencies like anaphylaxis may not happen frequently for this proficiency to occur. Simulation increases exposure to these rare events in a safe learning environment to improve skills and build confidence while standardizing curriculum. OBJECTIVE: Anesthesia residents participated in a simulated case of intraoperative pediatric anaphylaxis to evaluate knowledge and performance gaps...
February 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27939824/pulmonary-platelet-accumulation-induced-by-catecholamines-its-involvement-in-lipopolysaccharide-induced-anaphylaxis-like-shock
#12
Zhiqian Yu, Hiroko Saito, Hirotada Otsuka, Yosuke Shikama, Hiromi Funayama, Mai Sakai, Shigeo Murai, Masanori Nakamura, Takashi Yokochi, Haruhiko Takada, Shunji Sugawara, Yasuo Endo
Intravenously injected lipopolysaccharides (LPS) rapidly induce pulmonary platelet accumulation (PPA) and anaphylaxis-like shock (ALS) in mice. Macrophages reportedly release catecholamines rapidly upon stimulation with LPS. Here, we examined the involvement of macrophage-derived catecholamines in LPS-induced PPA and ALS. A catecholamine or Klebsiella O3 (KO3) LPS was intravenously injected into mice, with 5-hydroxytryptamine in the lung being measured as a platelet marker. The tested catecholamines induced PPA, leading to shock...
February 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/27923649/food-allergy-trends-and-epinephrine-autoinjector-presence-in-summer-camps
#13
Natalie R Schellpfeffer, Harvey L Leo, Michael Ambrose, Andrew N Hashikawa
BACKGROUND: Pediatric campers with food allergies are at greater risk for exposure and anaphylaxis. A diagnosis of asthma increases risk for anaphylaxis. Epidemiological investigations of food-allergic children at high risk for allergic reactions requiring intervention in camp settings are lacking. OBJECTIVE: The objectives of this study were to estimate the prevalence of food allergies among otherwise healthy campers in summer camps throughout the United States and Canada, and to assess asthma comorbidity and determine rates of epinephrine autoinjector prescriptions present in this population...
December 3, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27922561/a-pharmacologic-review-of-anaphylaxis
#14
Nancy S Yunker, Bradley J Wagner
Anaphylaxis occurs in the surgical population and may have devastating consequences. Anaphylaxis and anaphylactoid reactions are immediate hypersensitivity reactions that are most commonly precipitated by medications, insect stings, and foods. In the surgical population, 47.4% of immediate hypersensitivity reactions were precipitated by neuromuscular blocking agents, followed by latex and antibiotics in 20% and 18.1% of cases, respectively. Initial treatment consists of removing the precipitating trigger, administering epinephrine, and correct patient positioning...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27892597/a-multicenter-study-on-anaphylaxis-caused-by-peanut-tree-nuts-and-seeds-in-children-and-adolescents
#15
K Jeong, S-Y Lee, K Ahn, J Kim, H-R Lee, D I Suh, B-Y Pyun, T K Min, J-W Kwon, K-E Kim, K W Kim, M H Sohn, Y H Kim, T W Song, J H Kwon, Y H Jeon, H Y Kim, J H Kim, Y M Ahn, S Lee
Peanut (PN) and tree nuts (TNs) are common causes of anaphylaxis in Western countries, but no information is available in Korea. To feature clinical characteristics of anaphylaxis caused by PN, TNs, and seeds, a retrospective medical record review was performed in 14 university hospitals in Korea (2009-2013). One hundred and twenty-six cases were identified, with the mean age of 4.9 years. PN, walnut (WN), and pine nut accounted for 32.5%, 41.3%, and 7.1%, respectively. The median values of specific IgE (sIgE) to PN, WN, and pine nut were 10...
November 28, 2016: Allergy
https://www.readbyqxmd.com/read/27890557/anaphylaxis-in-a-health-maintenance-organization-international-classification-of-diseases-coding-and-epinephrine-auto-injector-prescribing
#16
Deena Pourang, Michael Batech, Javed Sheikh, Shefali Samant, Michael Kaplan
BACKGROUND: Accurate estimates of the incidence of anaphylaxis are limited. Current International Classification of Diseases, Ninth Revision (ICD-9) codes complicate accurate diagnosis of anaphylaxis and assessment of appropriate epinephrine prescribing. OBJECTIVE: To quantify the incidence and demographic character of patients with anaphylaxis-related ICD-9 codes in a large health maintenance organization and analyze epinephrine prescribing and dispensing rates...
November 24, 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27873193/childcare-and-school-management-issues-in-food-allergy
#17
REVIEW
Angela Tsuang, Julie Wang
PURPOSE OF REVIEW: The goal of this review is to characterize food allergy management and anaphylaxis in schools and assess current policies and level of preparedness of schools to recognize and treat anaphylaxis. RECENT FINDINGS: An increasing number of school-aged children have food allergies, and studies show that a significant number of school children with no known history of allergies will experience their first anaphylactic reaction at school. Stock-unassigned epinephrine auto-injectors are recommended in schools but not mandatory in most states, and therefore, epinephrine is not always available...
November 2016: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/27871512/case-report-management-of-differential-diagnosis-and-treatment-of-severe-anaphylaxis-in-the-setting-of-spinal-anesthesia
#18
Brian M Osman, Joni M Maga, Sebastian M Baquero
The purpose of this case report is to educate fellow anesthesiologists of a complicated differential diagnosis for sudden cardiovascular collapse after spinal anesthesia. We report a case where anaphylaxis occurred while under spinal anesthesia and resulted in difficult resuscitation. A 58-year-old woman undergoing bilateral knee replacements under spinal anesthesia experienced sudden seizure and cardiovascular collapse from acute anaphylactic shock while administering a cephalosporin. Local anesthetic toxicity, high spinal, and anaphylaxis were considered due to overlapping of symptoms...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869359/pitfalls-in-the-use-of-epinephrine-for-anaphylaxis-patient-and-provider-opportunities-for-improvement
#19
Michael B Cohen, Stefanie S Saunders, Sarah K Wise, Samih Nassif, Michael P Platt
BACKGROUND: Epinephrine remains the mainstay of treatment for life-threatening allergic reactions. A number of challenges are encountered with epinephrine, resulting in underutilization and misutilization of epinephrine. The purpose of this study was to identify the scope of epinephrine pitfalls and opportunities for improvement in the management of allergy emergencies. METHODS: A PubMed search from 1990 to 2015 was performed to identify all cases and reports pertaining to the use and misuse of epinephrine for anaphylaxis...
November 21, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27833688/autoinjectors-preferred-for-intramuscular-epinephrine-in-anaphylaxis-and-allergic-reactions
#20
Ronna L Campbell, M Fernanda Bellolio, Megan S Motosue, Kharmene L Sunga, Christine M Lohse, Maria I Rudis
INTRODUCTION: Epinephrine is the treatment of choice for anaphylaxis. We surveyed emergency department (ED) healthcare providers regarding two methods of intramuscular (IM) epinephrine administration (autoinjector and manual injection) for the management of anaphylaxis and allergic reactions and identified provider perceptions and preferred method of medication delivery. METHODS: This observational study adhered to survey reporting guidelines. It was performed through a Web-based survey completed by healthcare providers at an academic ED...
November 2016: Western Journal of Emergency Medicine
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