August 13, 2018

Is Epinephrine Essential for Anaphylaxis Treatment?

A severe form of an allergic reaction, such as anaphylaxis requires an immediate emergency medical treatment. Epinephrine or adrenaline is the first-line treatment for an anaphylactic reaction. If you or someone around you shows any signs of anaphylaxis, the instructions are clear: inject epinephrine into the lateral aspect of the thigh muscle.

 

Even if the cause of a reaction is not obvious, the medication should be administered without hesitation. Otherwise, there is an increased risk of lethal consequences.

However, despite the evidence-based effectiveness of epinephrine in case of severe allergic reactions, many people do not follow the guidelines and refrain from using epinephrine in patients with anaphylaxis symptoms.

A recent study looked at how anaphylaxis is managed in 10 different countries in Europe. The study found that healthcare professionals used epinephrine to treat the reaction only in 25 percent of cases, while lay helpers gave this medication to only one in seven patients with anaphylaxis symptoms. According to the study, these numbers have been increasing over the past ten years, in case of medical specialists.

The researchers did not manage to determine why exactly the caregivers refused to use epinephrine for the treatment of anaphylaxis. According to the respondents, the decisions were not based on the age of the patient and other related factors or the trigger of the reaction (e.g. some food allergen, an insect sting or a drug).

The study also found that an epinephrine injection was more likely to be used in patients who showed life-threatening symptoms like respiratory or cardiac arrest. Yet, about 30 percent of patients with severe symptoms did not receive epinephrine.

Some experts believe this may be related to the lack of scientific evidence for epinephrine’s efficacy against anaphylaxis, since the currently available evidence is mostly anecdotal. According to these experts, there haven’t been any scientific trials to assess the effectiveness of the anaphylaxis treatment with epinephrine.

It’s well-known that inadequate or delayed use of epinephrine in anaphylaxis may lead to severe and even fatal consequences. Therefore, the scientific evidence is required to ensure the appropriate anaphylaxis management.

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