Introduction
Anaphylaxis is a rapidly progressing, potentially life threatening allergic reaction that has been increasing in prevalence, most commonly triggered by foods, medications, and insect stings. Allergies in children are increasingly more common. Unfortunately, anaphylactic reactions are under-recognized, due to overlooked or under-appreciated symptoms, and therefore under-treated with epinephrine.[1] For several years, epinephrine has been established as the drug of choice for anaphylaxis.[2] Even a few minutes delay in the recognition and treatment of anaphylaxis can lead to hypoxia or death. Therefore, healthcare professionals and laypeople alike should be able to recognize the signs and symptoms of anaphylaxis and have accessible resources to initiate treatment.
Broadened awareness of the need for emergent anaphylactic treatment with readily available epinephrine auto-injectors, analogous to the common awareness and use of publicly housed automated external defibrillators (AEDs) in cardiac arrest, may decrease the morbidity and mortality of this rapidly progressing disorder. In 2006, Lieberman et al. reviewed articles since 1968 regarding epidemiological studies of anaphylaxis, finding approximately 50–2,000 episodes per 100,000 people with the largest incidence among children and adolescents;[3] mortality rates approximate 0.65 to 2%.[4] Boyce et al. found anaphylaxis accounted for 1 to 70 per 100,000 hospitalizations or emergency department visits.[5] In 2014, Ma et al. demonstrated the annual number of hospitalizations related to anaphylaxis increased from 5,700 to 7,700 from 1999 to 2009, and from 2006 to 2009 anaphylaxis related emergency department visits and hospitalizations increased from 25,000 to 30,000 annually.[6] The most recent figures, published in 2014, estimate the prevalence of anaphylaxis in the general population to be at least 1.6%, although probably higher.[7] While literature strongly suggests the need for available epinephrine in schools to treat anaphylaxis,[8] often triggered by foods, it seems reasonable and logical to have epinephrine auto-injectors available in populated public areas, similar to those where AEDs are available, for the life-saving treatment of anaphylactic reactions triggered by any allergen.
Western J Emerg Med. 2015;16(3):385-387. © 2015 Western Journal of Emergency Medicine
