This study included 213 anaphylactic reactions in 192 children in an urban pediatric emergency department (PED). The median age was 8 years. The triggers included the following:
- foods, 71%
- unknown, 15%
- drugs, 9%
Food was more likely to be a trigger in multiple PED visits.
Epinephrine was administered in 79% reactions. In 27% of reactions epinephrine was administered before arrival in the PED.
15% of patients were hospitalized.
For 6% of the reactions, 2 doses of epinephrine were administered (classically, 20% of patients need 2 doses of EpiPen).
Food is the main anaphylaxis trigger in the urban PED.
Editor's note: Epineprine autoinjectors (EpiPen, etc.) are supposed to be used prior to the arrival in the ED. The rule in anaphylaxis is: use your EpiPen first, call 911 next. The fact that only 27% of families followed this simple guidance shows room for improvement in patient education.
References:
Anaphylaxis in a New York City pediatric emergency department: Triggers, treatments, and outcomes. Huang F, Chawla K, Järvinen KM, Nowak-Węgrzyn A. J Allergy Clin Immunol. 2011 Oct 22.
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