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.authorTurner, Paul J.
dc.contributor.authorDunn Galvin, Audrey
dc.contributor.authorHourihane, Jonathan O'B.
dc.contributor.funderMedical Research Councilen
dc.contributor.funderNational Institute for Health Researchen
dc.contributor.funderImperial College Londonen
dc.date.accessioned2019-10-30T06:01:08Z
dc.date.available2019-10-30T06:01:08Z
dc.date.issued2016-06-07
dc.description.abstractFatal 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationTurner, 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.2016.05.005en
dc.identifier.doi10.1016/j.jaip.2016.05.005en
dc.identifier.eissn2213-2198
dc.identifier.endpage1146en
dc.identifier.issn2213-2201
dc.identifier.issued6en
dc.identifier.journaltitleJournal of Allergy and Clinical Immunology: In Practiceen
dc.identifier.startpage1143en
dc.identifier.urihttps://hdl.handle.net/10468/8916
dc.identifier.volume4en
dc.language.isoenen
dc.publisherElsevier B.V.en
dc.relation.projectinfo: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.relation.urihttps://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.2016.05.0051143en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectFood allergyen
dc.subjectAnaphylaxisen
dc.subjectEpinephrineen
dc.subjectAutoinjectoren
dc.subjectEmergency managementen
dc.titleThe emperor has no symptoms: the risks of a blanket approach to using epinephrine autoinjectors for all allergic reactionsen
dc.typeArticle (peer-reviewed)en
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