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PostPosted: Fri Apr 13, 2007 6:35 pm 
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Location: Toronto
New Pediatric Guidelines Issued For Epinephrine Use In Possibly Fatal Allergy Attacks

March 29, 2007 9:55 a.m. EST

Patricia Shehan - All Headline News Staff Writer

(AHN) - The American Academy of Pediatrics (AAP) issued new guidelines for the pediatric care of administering epinephrine to children who may suffer from potentially fatal allergic reactions.

"Anaphylaxis is a severe, potentially fatal systemic allergic reaction that is rapid in onset and may cause death," reports Scott H. Sicherer, MD, and colleagues from the Allergy and Immunology Section of the AAP.

An anaphylaxis attack can be triggered by foods or other allergens. However, insect bites are the most frequently reported cause of this type of reaction that usually requires emergency care.

"Epinephrine is the primary medical therapy, and it must be administered promptly... Prompt injection of epinephrine is nearly always effective in the treatment of anaphylaxis, and delayed injection of epinephrine is associated with poor outcomes including fatality," adds Sicherer and colleagues.

Read rest at:
http://www.allheadlinenews.com/articles/7006890753

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Allergic to soy, peanut, shellfish, penicillin


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PostPosted: Sun Apr 15, 2007 12:13 pm 
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Joined: Tue Nov 29, 2005 4:04 pm
Posts: 2044
Location: Gatineau, Quebec
I'm very glad that they included this:

Quote:
Recommended guidelines of epinephrine for administration now include "possibly even in the absence of symptoms if there was a known exposure to an allergen that previously caused anaphylaxis with cardiovascular collapse."


That is what we were instructed for our kids for peanut and for dairy for my youngest. I will not even wait to see symptoms if I know he has ingested any form of dairy, given that twice in the past it's caused anaphylaxis for him... And that is what I tell caregivers as well.

K.

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Karen, proud Mom of
- DS1 (12 yrs): allergic to cashews, pistachios, Brazil nuts, potatoes, some legumes, some fish, pumpkin seeds; OAS
- DS2 (1o yrs): ana. to dairy, eggs, peanuts; asthma


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PostPosted: Fri Apr 20, 2007 11:51 am 
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Joined: Sat Oct 01, 2005 8:55 pm
Posts: 412
Location: Vancouver, BC
I was happy to see that they had included that line, too. I volunteered at the CSACI conference when it came to Vancouver, and so I got to sit in on a dew discussions and one was the Epipen. The Allergists were all debating when to give the Epipen, and this same discussion comes up at every workshop I give. The Allergist who I think said it best said:

"If you KNOW or SUSPECT that a person with a history of LTA's has ingested the allergen, give it right away, do not wait for symptoms."

I think that "KNOW OR SUSPECT" is so good, because it let's people know that it's okay to give the epipen when they're just not sure. I always write it in Aaron's school plan. His bloodwork indicated that he would have a 95% chance of anaphylaxis from peanut, so that's good enough odds for me to give him the epipen before waiting to see if he's in difficulty. Otherwise, I end up saying things like, well, hives are probably okay, but if his breathing is laboured, give the pen. I mean, how do I really know what the cut off is and what's going on inside his body?

One time he stood on a shell accidentally and he got a welt on his foot (he was wearing a sock) and on his arm - I think his arm must have touched something as he was taking off his sock, and I didn't give him the Epipen, and nothing further happened.

Another time at school his torso went into welts after wearing a gym pinney, and they phoned me. And he was fine with just anti-histimine too. But I know that if I thought he had eaten something or if he said his mouth was starting to tingle, I would give him the Epipen right away.

I am wondering if anyone has got information on how to de-sensitize yourself re: the Epipen. Some people are really scared, and at the last workshop I did there was a young woman who was terrified that she would have a reaction by herself as she honestly felt that she would not be able to administer the Epipen herself. I gave her the trainer to practice with, and I let her have an expired Epipen and give it through a paper cup (I like using upside down paper cups rather than an orange cos you can see how little force is needed to set the thing off, and you get to see how much medicine is delivered - less than a teaspoon) - but I went away really concerned for her. Any tips?


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PostPosted: Fri Apr 20, 2007 4:20 pm 
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Location: Gatineau, Quebec
One of my local members has had to give her kids the EpiPen a few times. (It's not that they take a lot of risks - it's just that she has 2 allergic kids and each has required it once.)

She focussed on two things:

1. The first time, she thought about all the stories that she had heard (courtesy of me and the group) about how people have died when they haven't gotten the EpiPen in time, especially when they were asthmatic (which her youngest is). That motivated her to not second guess herself and just give the darn EpiPen to her child. (Her dairy-allergic DD had broken the fridge lock and helped herself to a Minigo yogurt!!)

2. The second time her son's symptoms were not horrendous, but he was experiencing some distress. He had not eaten anything unsafe as far as they knew (it turned out to be a new allergy.) She focussed again on how it was important to give the EpiPen in time, and this time (because of experience) on how much better her child would feel, and how quickly he would feel better. It really is a miracle drug - the effect is very rapid.

So in our group, we tell people to try not to think about the needle, and to focus on what will happen after the needle is given - that is, how much better you or your child will feel.

Sort of like: it's not what's on the outside that counts (the needle), but what's on the inside (the epinephrine).

K.

_________________
Karen, proud Mom of
- DS1 (12 yrs): allergic to cashews, pistachios, Brazil nuts, potatoes, some legumes, some fish, pumpkin seeds; OAS
- DS2 (1o yrs): ana. to dairy, eggs, peanuts; asthma


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