Kids May Need Two EpiPens

A major study just out in the journal Pediatrics (Rudders, Susan Pediatrics, April 2010; vol 125: pp: e711-e718) has been making headlines in newspapers all over the country. Dr. Rudders' teams looked at 1255 children who were admitted to emergency rooms at two large Boston hospitals between 2001 and 2006. All the children were under 18, but the average age was closer to six. Just over half (52%) of the children had a true anaphylactic reaction. Of these 44% received epinephrine and 12% of these needed two shots. Some of these shots were given at home, some at the hospital.

That's an awful lot of anaphylactic children who received no epinephrine at all. A Reuters article summed up the study's findings of the failings.

What's troubling, the researchers say, is that half of the children with food-induced anaphylactic reactions did not get epinephrine either before getting to the hospital or while at the hospital. At the hospital, the children received antihistamines, steroids, intravenous fluids and inhaled medicines more often than epinephrine, "despite the lack of evidence" for their usefulness as a first-line treatment, the authors note.

Additionally, fewer than half of the children with food-related allergic reactions left the hospital with a prescription for self-injectable epinephrine and only 22 percent were advised to see an allergist.

Clearly, food-related anaphylaxis "continues to be under-recognized and inadequately treated," Rudders and colleagues warn. Estimates suggest that approximately 150 to 200 people die each year from food-related anaphylactic reactions, and delayed or lack of administration of epinephrine is often to blame.

UPI had a further important quote.

"Until we're able to clearly define the risk factors for the most severe reactions, the safest thing may be to have all children at risk for food-related anaphylaxis carry two doses of epinephrine," first author Dr. Susan Rudder says in a statement.

To offset costs, Rudders suggests, school nurses carry un-assigned extra doses of injectable epinephrine for the children who need them.

Anaphylaxis - Life-Threatening Allergy

I found an excellent article on anaphylaxis on the AAIR (Asthma and Allergy Information & Research) site. Information and Research. My heart is beating faster already.

And much good informtion there is.

How can you tell if someone is having anaphylaxis?
Anaphylaxis usually happens quickly.
Anaphylaxis can produce:

• An itchy nettlerash (urticaria, hives)
• Faintness and unconsciousness due to very low blood pressure. Unlike an ordinary fainting attack, this does not improve so dramatically on lying down.
• Swelling (angioedema)
• Swelling in the throat, causing difficulty in swallowing or breathing
• Asthma symptoms
• Vomiting
• Cramping tummy pains
• Diarrhoea
• A tingling feeling in the lips or mouth if the cause was a food such as nuts
• Death due to obstruction to breathing or extreme low blood pressure (anaphylactic shock)

And a table of epinephrine injectors.

What is the best treatment for anaphylaxis?

Although there are several important treatments, by far the most important
is:

Adrenaline (epinephrine)

There is one drug which will work against all the effects of all the dangerous substances released in anaphylaxis. It is adrenaline (epinephrine). For serious attacks, it is a vital treatment. You need to inject it; inhalers may no longer be an option.

There are special syringe kits to make injection easy:

Name of injection kit	Country (incomplete list)	Dose	Source	Comment
Epipen	USA, Europe	Adult 0.3 mg Child 0.15 mg	Dey Laboratories (USA) ALK (Eur)	Long-established
Anapen	UK	Adult 0.3 mg Child 0.15 mg	Lincoln Medical Limited, UK	Identical drug & dose to Epipen. Easy to use.
AnaKit	USA	2 doses of 0.3 mg: other doses possible	Bayer	Long-established. Red box also contains antihistamine tablets and flimsy tourniquet (for bee or wasp sting).
Anaguard	USA,also available elsewhere.	As AnaKit	Bayer	Syringe as AnaKit, pen-like container is compact and strong, no tablets or tourniquet.
Min-I-Jet	UK	1 mg, other doses possible	IMS, UK	Seems designed more for hospital use.

Take In Case EpiPen Holders

Need to be sure your child or loved one has an EpiPen on his or her body at all times? Don't want to take the chance that it got left behind, or stuffed in the wrong pocket of the wrong coat? TAKE IN CASE provides a variety of solutions as close as clothing.

According to the press release the company just issued,

Halloween Safety experts Kim Hartman and Maureen Cooney ... invented and produced TAKE IN CASE(TM) as a comfortable, discreet, secure, wearable sleeve-like case to be worn on the shin, thigh, upper arm by people with severe allergies who are on the go and need to have their EpiPen(R) Auto-Injectors with them at all times.



"When my son was diagnosed with food allergies, I knew it wasn't going to be easy," says TAKE IN CASE(TM) co-creator Kim Hartman. "As a mother, being vigilant about his well-being is second-nature. Making sure that he always has his EpiPen(R) Auto-Injectors and that he knows how to administer them properly is very important. TAKE IN CASE(TM) achieves two goals, it enables my son to carry his medicine in a convenient, discreet manner to movies, ball games or a friend's house and it also gives me peace of mind knowing that he's safe!"

You can check out their complete line of products at their website, www.takeincase.com.