The emperor has no symptoms: the risks of a blanket approach to using epinephrine autoinjectors for all allergic reactions

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dc.contributor.author Turner, Paul J.
dc.contributor.author Dunn Galvin, Audrey
dc.contributor.author Hourihane, Jonathan O'B.
dc.date.accessioned 2019-10-30T06:01:08Z
dc.date.available 2019-10-30T06:01:08Z
dc.date.issued 2016-06-07
dc.identifier.citation Turner, P. J., DunnGalvin, A. and Hourihane, J. O. B. (2016) 'The Emperor Has No Symptoms: The Risks of a Blanket Approach to Using Epinephrine Autoinjectors for All Allergic Reactions', The Journal of Allergy and Clinical Immunology: In Practice, 4(6), pp. 1143-1146.(4pp.) DOI: 10.1016/j.jaip.2016.05.005 en
dc.identifier.volume 4 en
dc.identifier.issued 6 en
dc.identifier.startpage 1143 en
dc.identifier.endpage 1146 en
dc.identifier.issn 2213-2201
dc.identifier.uri http://hdl.handle.net/10468/8916
dc.identifier.doi 10.1016/j.jaip.2016.05.005 en
dc.description.abstract Fatal anaphylaxis in humans is rare and unpredictable. We note a trend to provide allergic individuals with care plans that recommend immediate use of epinephrine autoinjectors if allergen ingestion is suspected, even in the absence of any allergic symptoms, without any supporting evidence base. Instructions to use an autoinjector device, irrespective of reaction severity and especially when symptoms are actually absent, are likely to add to parental and patient anxiety. Of greater concern is the possibility of epinephrine being administered “too early” to treat initial, mild symptoms that then progress to severe anaphylaxis. It is not hard to visualize a scenario where one or both epinephrine autoinjectors have been deployed for mild symptoms, yet the reaction progresses to a severe reaction and no further epinephrine is available for administration. Epinephrine needs to be available as a rescue treatment for anaphylaxis, potentially buying valuable minutes while emergency medical services are activated to attend. Food-allergic individuals and their carers need to be provided with more constructive strategies and support than merely being told to “use your pen.” en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier B.V. en
dc.relation.uri https://www.sciencedirect.com/science/article/pii/S2213219816301416?via%3Dihub
dc.rights ©2016 The Authors. Published by Elsevier Inc. on behalf of the American Academyof Allergy, Asthma & Immunology. This is an open access article under the CCBY license (http://creativecommons.org/licenses/by/4.0/).http://dx.doi.org/10.1016/j.jaip.2016.05.0051143 en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Food allergy en
dc.subject Anaphylaxis en
dc.subject Epinephrine en
dc.subject Autoinjector en
dc.subject Emergency management en
dc.title The emperor has no symptoms: the risks of a blanket approach to using epinephrine autoinjectors for all allergic reactions en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Audrey DunnGalvin, School of Applied Psychology, University College Cork, Cork, Ireland. +353-21-490-3000 Email:a.dunngalvin@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Medical Research Council en
dc.contributor.funder National Institute for Health Research en
dc.contributor.funder Imperial College London en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Allergy and Clinical Immunology: In Practice en
dc.internal.IRISemailaddress a.dunngalvin@ucc.ie en
dc.relation.project info:eu-repo/grantAgreement/RCUK/MRC/MR/K010468/1/GB/Mechanisms underlying the physiological and cellular response to food allergen challenge in human subjects with peanut allergy/ en
dc.identifier.eissn 2213-2198


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©2016 The Authors. Published by Elsevier Inc. on behalf of the American Academyof Allergy, Asthma & Immunology. This is an open access article under the CCBY license (http://creativecommons.org/licenses/by/4.0/).http://dx.doi.org/10.1016/j.jaip.2016.05.0051143 Except where otherwise noted, this item's license is described as ©2016 The Authors. Published by Elsevier Inc. on behalf of the American Academyof Allergy, Asthma & Immunology. This is an open access article under the CCBY license (http://creativecommons.org/licenses/by/4.0/).http://dx.doi.org/10.1016/j.jaip.2016.05.0051143
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