Allergic reactions in the community: a questionnaire survey of members of the anaphylaxis campaign

Uğuz, Ayşen; Lack, Gideon; Pumphrey, R. S. H.; Ewan, P. W.; Warner, John O.; Dick, Jackie Traher; Briggs, David; Clarke, Sue; Reading, David; Hourihane, Jonathan

doi:10.1111/j.1365-2222.2005.02257.x

Cited by 163 publications

(137 citation statements)

References 20 publications

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“…In retrospective studies [35][36][37] 18% to 35% of patients having signs of anaphylaxis required a second dose of epinephrine if symptoms persisted or progressed after the first dose. Because of the difficulty in making a diagnosis of anaphylaxis [27][28][29][30]38,39 and the potential harm from epinephrine if the diagnosis is incorrect, 40 -43 first aid providers are advised to seek medical assistance if symptoms persist, rather than routinely administering a second dose of epinephrine.…”

Section: Anaphylaxismentioning

confidence: 99%

Part 17: First Aid

Markenson¹,

Ferguson²,

Chameides³

et al. 2010

Circulation

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Section: Anaphylaxismentioning

confidence: 99%

Part 17: First Aid

Markenson¹,

Ferguson²,

Chameides³

et al. 2010

Circulation

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“…According to the anaphylaxis registries of different European countries, next to exercise, alcohol consumption is a relevant cofactor in up to 15.2% of anaphylactic events and drugs such as ASA were registered as a cofactor in 6.1-9% of severe anaphylactic reactions (Table 1). The role of infections as cofactors of anaphylaxis is reported to be relevant in 2.5-3% of anaphylactic reactions in children and in 1.3-11% in adults (8,(13)(14)(15)(16)(17)(18). Infections are particularly dangerous for patients with a risk to develop anaphylaxis, because in contrast to most other relevant cofactors of anaphylaxis, infections cannot simply be avoided or foreseen.…”

mentioning

confidence: 99%

About the role and underlying mechanisms of cofactors in anaphylaxis

Wölbing

Fischer

Köberle

et al. 2013

Allergy

178

163

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Anaphylaxis is the systemic and most severe presentation of type I allergy. A number of conditions were identified that modulate the onset of anaphylaxis such as co-or augmentation factors, which significantly lower the allergen dose necessary for triggering anaphylaxis. Next to physical exercise or alcohol consumption, co-administration of nonsteroidal anti-inflammatory drugs (NSAID) or concomitant infectious diseases are well-documented cofactors of anaphylaxis. Registries for anaphylaxis document a role for cofactors in about 30% of anaphylactic reactions. Some disease entities such as 'wheat-dependent exercise-induced anaphylaxis' (WDEIA) are explicitly characterized by elicitation of anaphylaxis only in the presence of at least one such cofactor. Using WDEIA as a model disease, studies demonstrated that exercise increases skin prick test reactivity to and bioavailability of the allergen. Additional data indicate that alcohol consumption and NSAID administration display similar effects. Modulation of the cellular activation threshold is another mechanism underlying cofactor-induced anaphylaxis, most likely also functional when infectious diseases orchestrate elicitation of anaphylaxis. Cofactors are increasingly accepted to play a fundamental role in eliciting anaphylaxis. Consequently, to improve patient management modalities, a better understanding of the underlying mechanisms is warranted. This review aims to update clinicians and clinical scientists on recent developments.

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“…29,30 As stated previously, some of the effects of epinephrine (pallor, tremor, anxiety, and palpitations) and even severe adverse effects (such as cough from pulmonary edema) can mimic some of the symptoms of anaphylaxis. Caregivers should be aware of these issues and avoid unnecessary repeat dosing.…”

Section: Epinephrine Autoinjectors: 015 or 030 Mg?mentioning

confidence: 99%

Self-injectable Epinephrine for First-Aid Management of Anaphylaxis

Sicherer¹,

Simons²

2007

Pediatrics

169

129

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Anaphylaxis is a severe, potentially fatal systemic allergic reaction that is rapid in onset and may cause death. Epinephrine is the primary medical therapy, and it must be administered promptly. This clinical report focuses on practical issues concerning the administration of self-injectable epinephrine for first-aid treatment of anaphylaxis in the community. The recommended epinephrine dose for anaphylaxis in children, based primarily on anecdotal evidence, is 0.01 mg/kg, up to 0.30 mg. Intramuscular injection of epinephrine into the lateral thigh (vastus lateralis) is the preferred route for therapy in first-aid treatment. Epinephrine autoinjectors are currently available in only 2 fixed doses: 0.15 and 0.30 mg. On the basis of current, albeit limited, data, it seems reasonable to recommend autoinjectors with 0.15 mg of epinephrine for otherwise healthy young children who weigh 10 to 25 kg (22-55 lb) and autoinjectors with 0.30 mg of epinephrine for those who weigh approximately 25 kg (55 lb) or more; however, specific clinical circumstances must be considered in these decisions. This report also describes several quandaries in regard to management, including the selection of dose, indications for prescribing an autoinjector, and decisions regarding when to inject epinephrine. Effective care for individuals at risk of anaphylaxis requires a comprehensive management approach involving families, allergic children, schools, camps, and other youth organizations. Risk reduction entails confirmation of the trigger, discussion of avoidance of the relevant allergen, a written individualized emergency anaphylaxis action plan, and education of supervising adults with regard to recognition and treatment of anaphylaxis.

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Allergic reactions in the community: a questionnaire survey of members of the anaphylaxis campaign

Cited by 163 publications

References 20 publications

Part 17: First Aid

Part 17: First Aid

About the role and underlying mechanisms of cofactors in anaphylaxis

Self-injectable Epinephrine for First-Aid Management of Anaphylaxis

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