| Repeat epinephrine treatments for food-related allergic reactions that present to the emergency department. | |
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MedLine Citation:
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PMID: 20819321 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Aleena Banerji; Susan A Rudders; Blanka Corel; Alisha M Garth; Sunday Clark; Carlos A Camargo |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2010-09-07 Completed Date: 2011-06-14 Revised Date: 2011-08-12 |
Medline Journal Info:
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Nlm Unique ID: 9603640 Medline TA: Allergy Asthma Proc Country: United States |
Other Details:
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Languages: eng Pagination: 308-16 Citation Subset: IM |
Affiliation:
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Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. abanerji@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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51-43-4/Epinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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