Diane J. Dilay, RN, and Janet R. Roberts, MD, from the Meadowood Medical Centre and the University of Manitoba, Winnipeg, Canada analyzed survey results from 75 members of a support group for parents of children with anaphylaxis. The study set out to determine why well informed parents often fail to administer an EpiPen® when needed.

vOf the 41 respondents who reported one or more allergic reactions, 11 (27%) had used the EpiPen. The patients who were not administered the EpiPen showed symptoms of hives, respiratory distress, vomiting and abdominal pain, or lethargy. In those who had failed to administer the EpiPen, 72 percent felt the reaction had not been severe enough to warrant it.

Improves Chances of Survival

Several other reasons were given as well, including a hospital was close by, new trigger causing reaction, concern regarding side effects of the shot, pain from shot, EpiPen was not available, the child was frightened, and perception that the responsible allergen would cause only a mild reaction.

All 11 respondents who administered the EpiPen sought further treatment in the emergency room. Sixteen of the respondents who did not use the EpiPen did seek emergency room treatment. However, 14 of the patients did not receive either the EpiPen or emergency room treatment, despite showing allergic symptoms.

Using the EpiPen early in anaphylaxis improves the chances of survival and a quick recovery. It appears from this study that parental denial, or failure to appreciate the severity of a reaction, is the major obstacle to using this life-saving treatment. Recognizing this, and directing educational efforts to correct it, is an important aspect of managing allergic reactions in children.

AAAAI News Release

Title 10 anaphylaxis food death allergic reactions Despite being well educated about anaphylaxis, parents often fail to appreciate the severity of allergic reactions, according to a study. EpiPen Allergy Specialist Treatment Reduces Asthma Hospitalizations Allergy and Asthma - Treatment by Allergy Specialist Reduces Asthma Hospitalizations

Asthma sufferers who regularly use inhaled corticosteroids and are under the care of an allergy specialist are less likely to need emergency hospital care for their disease, according to a study in the Journal of Allergy and Clinical Immunology (JACI).

The JACI study is the largest of its kind to show the importance of an allergy specialist in the treatment of asthma. It is the first to explore the relationship between allergy specialty care, the dispensing of inhaled corticosteroids (IC), and the reduction of asthma related emergency department visits. Both adequate IC therapy (at least 4 canisters per year) and allergy specialty care are effective in preventing emergency hospital care for asthma. They have independent and additive effects in reducing emergency room visits for asthma.

Michael Schatz, MD, MS, FAAAAI, Kaiser-Permanente Medical Center, San Diego, and colleagues analyzed 9,608 asthma patients, ages 3-64 years, selected from the Southern California Kaiser-Permanente Asthma Case Identification Database. Inhaled steroid use and allergist care in 1999 were evaluated for their relationship to year 2000 emergency hospital care, while controlling for other severity and treatment parameters.

Key Study Findings

After analyzing the patients across the time points, researchers found:

  • Allergy specialty care resulted in a 27 percent reduction in emergency hospital care for asthma.
  • Patients using four or more canisters/year of IC required significantly less emergency hospital care for asthma, and those using seven or more were even less likely to require emergency care for asthma.
  • Patients receiving allergy specialty care were more likely to use seven or more canisters/year of IC.
  • Patients receiving allergy specialty care and using seven or more canisters/year of IC had a greater reduction in emergency hospital care for asthma.

Medication Important

Inhaled corticosteroids are recognized as the medications of choice for the treatment of chronic, persistent asthma by the National Asthma Education and Prevention Program (NAEPP) of the National Heart, Lung and Blood Institute (NHLBI). They are effective in reducing airway inflammation, hypersensitivity, swelling and mucous production. Previous findings show that using six or more canisters of IC a year reduces death caused by asthma.

The study also confirmed prior reports suggesting that allergy specialty care is effective in preventing emergency department visits and hospitalizations for asthma. The study showed that increased prescribing of inhaled corticosteroids is an important component of the effect of allergist care on reducing emergency hospital care.

Care Reduces Asthma

The findings from the study also suggested that other aspects of allergy specialist care, such as patient education, environmental control, use of other medications and immunotherapy probably contributed to a reduction in emergency hospital care as well.

Asthma is a chronic disease that affects more than 17 million people in the United States, accounting for $2.6 billion in hospitalizations and emergency room visits. The JACI study confirmed and extended previous findings showing that allergy specialty care reduces asthma hospitalizations, improves quality of life and reduces costs.