Document Detail


Repeat epinephrine treatments for food-related allergic reactions that present to the emergency department.
MedLine Citation:
PMID:  20819321     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To date, there are sparse data on epinephrine treatment for food-related anaphylaxis in adults. We sought to establish the frequency of more than one epinephrine treatment for adult patients who present with food-related anaphylaxis to the emergency department (ED). We performed a chart review, at two academic centers, of all adults presenting to the ED for food allergy (ICD9CM codes 693.1, 995.0, 995.1, 995.3, 995.7, 995.60-995.69, 558.3, 692.5, and 708.X) between January 1, 2001 and December 31, 2006. We focused on causative foods; treatments, including the number of epinephrine treatments given before and during the ED visit; and disposition. Through random sampling and appropriate weighting, the 486 reviewed cases represented a study cohort of 1286 patients. The median age was 36 years and the cohort was 62% women. Shellfish (23%), peanuts (12%), tree nuts (14%), and fish (14%) provoked the allergic reaction most commonly. Most patients (62%; 95% confidence interval [CI], 57-68%) met criteria for food-related anaphylaxis. In the ED, anaphylaxis patients received epinephrine (18%), antihistamines (91%), corticosteroids (81%), and inhaled albuterol (19%). Overall, 17% (95% CI, 9-25%) of patients with food-related anaphylaxis given epinephrine received >1 dose over the course of their reaction. Among anaphylaxis patients admitted to the hospital, only 10% included anaphylaxis in the discharge diagnosis. At ED discharge (82% of patients), 18% were referred to an allergist and 39% were prescribed self-injectable epinephrine. Among ED patients with food-related anaphylaxis treated with epinephrine, 17% were given >1 dose. This study supports the recommendation that patients at risk for food-related anaphylaxis should carry 2 doses of epinephrine.
Authors:
Aleena Banerji; Susan A Rudders; Blanka Corel; Alisha M Garth; Sunday Clark; Carlos A Camargo
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Allergy and asthma proceedings : the official journal of regional and state allergy societies     Volume:  31     ISSN:  1539-6304     ISO Abbreviation:  Allergy Asthma Proc     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-09-07     Completed Date:  2011-06-14     Revised Date:  2011-08-12    
Medline Journal Info:
Nlm Unique ID:  9603640     Medline TA:  Allergy Asthma Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  308-16     Citation Subset:  IM    
Affiliation:
Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. abanerji@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Anaphylaxis
Arachis hypogaea / adverse effects
Clinical Protocols
Emergency Service, Hospital / statistics & numerical data*
Epinephrine / administration & dosage*,  therapeutic use
Female
Food Hypersensitivity / diagnosis,  drug therapy*,  epidemiology*,  physiopathology
Humans
Male
Medical Records
Patient Education as Topic
Risk Factors
Shellfish / adverse effects
Treatment Outcome
Chemical
Reg. No./Substance:
51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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