Have a low threshold for using Epinephrine in suspected Anaphylaxis

The American College of Allergy just released an a article in the Annals of Allergy, Asthma and Immunology stating that epinephrine should be used in all cases of suspected anaphylaxis even if they do not meet all the established criteria for diagnosing this condition. Furthermore, the article states that epinephrine should be given to patients at risk of an anaphylactic reaction based on a previous severe reaction or those who have had a known or suspected exposure to their allergic trigger with or without the development of symptoms.

The rationale is that the consequences of not using epinephrine when it is needed are much more dire than the potential side effects when it is not necessary.

This is a relevant statement since it seems that it is not only patients or their families who are reluctant to use epinephrine, but also medical staff. A study done in the early 2000s showed that epinephrine was administered in only 62% of the fatal anaphylactic reactions that were reviewed by the researchers! I really do hope that this is not indicative of current practices. Epinephrine is a lifesaving drug that can very, very rarely cause an overdose.

Dr. Kevin talked about his approach to anaphylaxis and the importance of epinephrine on our 2nd podcast. Which you can access by clicking here.

Link to the ACA statement can be accessed here.

Posted on 6/08/2015 by Dr. Dimitre