Not Sure it's Anaphylaxis? When Emergency Personnel Should Administer Epinephrine Anyway


An article summarizing the recommendations of an expert panel of allergists and emergency personnel was published last week in the Annals of Allergy, Asthma and Immunology, and what it had to say is of special importance to people at risk for anaphylaxis.

It should be noted that the earlier a person suffering anaphylaxis receives epinephrine, the less severe the reaction may be and the less likely the victim will suffer a biphasic reaction (a second reaction) later on.

The problem is that symptoms of anaphylaxis do not always present the same way, causing medical personnel to delay administration of epinephrine because they’re not sure the patient is indeed having such a reaction.

The panel recommends that patients receive epinephrine even if they do not meet all the established criteria for anaphylaxis if: (1) they have had a previous severe reaction or (2) they have had a known or suspected exposure to their trigger with our without symptoms.

“Our emergency medicine colleagues told us that if patients don’t fit established guidelines for anaphylaxis, there may be a reluctance in the emergency room to treat with epinephrine,” said allergist Stanley Fineman, MD, ACAAI past president, and chair of the panel. “Because epinephrine is the first line of defense in treating anaphylaxis, the panel agreed it should be used – even if a patient’s reaction may not meet all the established criteria. The consequences for not using epinephrine when it’s needed are much more severe than using it when it might not be necessary.”

The panel also recommended that anyone visiting the emergency room for anaphylaxis schedule a followup visit with an allergist.

We at urge you to always Take 2… Take 2 epinephrine auto-injectors with you everywhere, every time; and be sure to let medical personnel know about your allergies when being treated for an emergency even if you are not sure you are suffering anaphylaxis.

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Dave Bloom
Dave Bloom
Dave Bloom is CEO and "Blogger in Chief" of

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