QuoteRelated: Free webinar from FARE on Wednesday, July 15 at 1pm ET. "Emergency Treatment of Anaphylaxis: Trends in Care and Steps to Improve It Among EMS Agencies and Hospitals."

Quote from: LinksEtc on December 02, 2014, 07:35:20 PM
Tweeted by @kfatweets

"Emergency Rooms Often Skip The Epinephrine For Severe Allergies"
http://www.npr.org/blogs/health/2014/12/02/367995894/emergency-rooms-often-skip-the-epinephrine-for-severe-allergies?utm_campaign=storyshare&utm_source=twitter.com&utm_medium=social

QuoteThat's why a joint task force of allergists published guidelines on Tuesday in the Annals of Allergy, Asthma and Immunology, reinforcing that emergency rooms should be using epinephrine "first and fast" to treat a severe allergic reaction.

QuoteThere are many reasons the article missed the mark about anaphylaxis and its treatment.

QuoteRecent evidence from American emergency departments suggests that emergency physicians use epinephrine appropriately in 98% of cases.

QuoteAt our recent Annual Scientific Meeting, we convened an anaphylaxis roundtable discussion between emergency room physicians and allergists.

QuoteThat's why a joint task force of allergists published guidelines on Tuesday in the Annals of Allergy, Asthma and Immunology, reinforcing that emergency rooms should be using epinephrine "first and fast" to treat a severe allergic reaction.

QuoteEpinephrine was not administered in almost half of moderate-to-severe cases, and similar numbers of individuals with moderate-to-severe reactions were not prescribed an epinephrine autoinjector.

QuoteThere is non-adherence to guidelines recommending epinephrine use for all cases of anaphylaxis. We postulate that this may be related to concerns regarding the side effects of epinephrine in adults.

QuoteDespite the fact that many guidelines are created after systematic reviews and meta-analyses – processes we would never have time to go through ourselves – we, like our own patients, are often noncompliant.

QuoteSignificantly higher proportions of patients with anaphylaxis received epinephrine and were admitted to the ED observation unit after introduction of epinephrine autoinjectors and order set implementation. Slightly more than half of the biphasic reactions occurred within the recommended observation time of 4 to 6 hours. Analysis of these data suggests that the multifaceted approach to changing anaphylaxis management described here improved guideline adherence.

QuoteCONCLUSION: Epinephrine by intramuscular injection is a safe therapy for anaphylaxis but training may still be necessary in emergency care settings to minimize drug dosing and administration errors and to allay concerns about its safety.

QuoteDr. Randolph is a member of the Joint Task Force on Practice Parameters, a team of physicians appointed by the American College of Allergy, Asthma & Immunology (ACAAI) and the American Academy of Allergy, Asthma & Immunology (AAAAI) to craft the new ER treatment guidelines. He expects the guidelines will be published in a medical journal this year.