Anaphylaxis: An Underrecognized Killer

By Leslie Coplin, Executive Editor, AHC Media

Anaphylaxis is a severe, life-threatening reaction to an allergen that involves multiple organ systems or reduced blood pressure. Recently, the American Academy of Pediatrics (AAP) updated its 2007 clinical guidance on the use of epinephrine for management of anaphylaxis in children.

“Anaphylaxis kills. Clinicians’ ability to make an accurate diagnosis and put the life-saving tool of epinephrine in the hands of those who care for the child can truly save a life,” says Ann M. Dietrich, MD, FACEP, FAAP, editor of Pediatric Emergency Medicine Reports. “This report is invaluable to clinicians.”

The AAP report includes information for healthcare providers on how to recognize anaphylaxis and provide first-aid treatment, including new information on the use of epinephrine. Key points highlighted include:

• Clinical criteria for diagnosis — validated in emergency department studies involving children, teenagers, and adults — are available to ensure prompt diagnosis and treatment.
• Administering epinephrine as the medication of choice is associated with a lower risk of hospitalization and fatality.
• Prescribing epinephrine autoinjectors for patients at high risk of anaphylaxis leads to prompt administration in non-healthcare settings. Clinicians should exercise caution when prescribing to children and infants who weigh less than 15 kg.
• Community education programs that involve children, families, preschools, schools, camps, and sports organizations are needed to recognize and treat anaphylaxis in the community.
• Personalized emergency action plans, which include triggers, allergens, and therapies, are useful to prevent future anaphylaxis recurrences.

“Studies have shown time and again that, as healthcare providers, we still need to improve in our recognition, treatment, and patient education for allergies and anaphylaxis,” writes John Cheng, MD, Pediatric Emergency Medicine Associates, Atlanta, GA. Dr. Cheng’s complete review of anaphylaxis will appear in the August issue of Pediatric Emergency Medicine Reports.