Anaphylaxis Info for Patients, Families & Schools
"Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death."
Important anaphylaxis facts:
- Anaphylaxis can be effectively treated if early signs are recognized by our patients, their families and other supervising adults, and by aggressive early intervention with epinephrine
- Each year in the United States, there are estimated to be about 100,000 cases of anaphylaxis, and almost 1% are fatal.
- Rates of food allergy have doubled in the past ten years, now estimated at 4% of the US population.
- About 90 percent of all food reactions are due to eight main triggers: milk, eggs, soy, wheat, peanuts, tree nuts, fish and shellfish.
- Other triggers include stings and bites, latex, radiology-contrast media, cold temperature exposure or even exercise. 20 percent or more of anaphylaxis cases do not have a known cause.
The Children's Physician Network Anaphylaxis Work Group comprised of Pediatricians, Allergists, Nurses and Parent Advocates, was formed to:
- Simplify the decision tree for a parent, teacher, caregiver or patient themselves for when to administer epinephrine .
- Define when to use an action plan: Recommend use for EVERY person who is prescribed an EpiPen or Twinject.
- Standardize an action plan to be used across our medical community so that schools and daycares are not flooded by many different forms to interpret (especially when in the midst of a crisis). Other action plans should be discarded.
- Create an action plan that is easy for a health care clinician in a busy office practice to complete.
- Comply with Minnesota law requiring a medically supervised action plan with an epinephrine auto-injector prescription.
- Review data, provider tools, websites and patient/parent handouts, and compile the most useful materials in one location for easy access to all utilizing the CPN website, allowing timely periodic updates/revisions.
- A note on dosing: In December 2010, the National Institute of Allergy and Infectious Disease (NIAID) published the Guidelines for the Diagnosis and Management of Food Allergy* in which the following dosing for Epinephrine is listed (p. 22):
- Epinephrine, IM; auto-injector or 1:1,000 solution
- Weight 10-25 kg: 0.15 mg epinephrine autoinjector, IM (anterior-lateral thigh)
- Weight >25 kg: 0.3 mg epinephrine autoinjector, IM (anterior-lateral thigh)
- Epinephrine doses may need to be repeated every 5-15 minutes
The Guideline also states that Epinephrine is the first-line treatment in all cases of anaphylaxis. All other drugs have a delayed onset of action.
The dosing on the revised Anaphylaxis Plan reflects the latest dosing recommendations based upon the NIAID Guideline. These recommendations differ from those found in other sources, including the EpiPen TM JR and EpiPen TM package inserts.