EpiCenter Medical, Inc was founded by allergist Dr. Mark Greenwald and lawyer Elizabeth Goldenberg

A comprehensive new training course for understanding and managing anaphylactic emergencies has just launched online.

“First Aid For Anaphylaxis: An Allergic Emergency” fills an important educational gap by providing clear instructions for what steps to take if witnessing an anaphylactic reaction. It provides easy-to-follow, standardized information in line with World Allergy Organization (WAO) guidelines.

“We have created this course to protect allergic individuals by ensuring that the first on the scene are trained to recognize an allergic emergency – anaphylaxis – and respond immediately with life-saving first aid,” said Dr. Mark Greenwald, the Toronto allergist who co-created the course with Elizabeth Goldenberg, a lawyer and allergy advocate.

“This medical emergency requires immediate first aid – the individual can’t wait for emergency crews to arrive,” said Greenwald, referring to the need for quick response with emergency epinephrine when an anaphylactic reaction is in progress.

Greenwald and Goldenberg founded EpiCenter Medical Inc., the company that offers this online course, which provides excellent guidance for parents of allergic children, their caregivers and school and daycare staff. But the course is also designed to be used more widely in the community: staff in restaurants, dental offices, airlines, government offices, hotels, and sports venues are among those Greenwald sees benefiting from its emergency training.

“When staff in those locations are called to respond to a reaction on their premises, they will know how to recognize anaphylaxis, to treat anaphylaxis immediately with epinephrine for the best survival rate, and what life-saving steps to take next,” he says.

Anyone with Internet access can take the course, which is divided into modules:

• It begins with definitions of allergy and anaphylaxis, and moves into an explanation of epinephrine and easy instructions on how to use an epinephrine auto-injector. (So far, the course gives details on the widely prescribed EpiPen, but this may be updated soon to include the new Auvi-Q/Allerject injector.)
• As the lessons progress, participants learn how to spot anaphylaxis, and are given clear steps to follow (and remove any lingering doubt) during an anaphylactic emergency.
• As legal questions can arise among would-be good Samaritans, legal consequences are also covered, from injecting the life-saving shot into someone else, to the ramifications of deciding not to do so.

To confirm the participant’s comprehension (and keep the user engaged), quizzes are taken throughout to test knowledge. Users cannot move on to the next section until they have passed the previous one.

Allergic Living was glad to see that EpiCenter Medical’s course stresses that it’s always better to give the shot, and immediately, in the case of a suspected anaphylactic reaction. Delay can reduce the chance of epinephrine being effective, and there are no harmful effects associated with giving the shot to a healthy person who doesn’t require it.

Those who complete the online course are able to print out a personal certificate stating that they are S.A.V.E. certified – which stands for Save Anaphylaxis Victims in an Emergency.

EpiCenter Medical also offers sale of an ‘Epi-Kit’, which is a case of multiple EpiPens designed to be placed in public locations, in a manner similar to automated external defibrillators. The idea is that an Epi-Kit should always be available within 60 seconds of an anaphylactic emergency.

In summary: This course provides highly valuable information and life-saving instructions. It is excellent as a standalone course, and could also be integrated into CPR courses, so that any first responder in an anaphylactic emergency will know what steps to take to save a life.

The course is available at epipentraining.com
Cost for an individual: $29.95
Discounted group rates available for groups larger than 10

On April 7, 2013, Adrian Gutierrez, an 8-year-old boy from Monmouth County, New Jersey, experienced a severe reaction and died in hospital. The reaction came over the boy on his family’s drive home from church, following a visit to a coffee shop. The boy’s mother suspects that Adrian, who was allergic to dairy and peanuts, may have accidentally sipped from his brother’s hot chocolate with milk. (Adrian had ordered a hot chocolate with  soy milk.)

One news report stated that an epinephrine auto-injector was administered to the boy. However, it is not clear whether the shot was given immediately after the reaction began, or  whether there was a significant delay. In the case of a severe allergic reaction, epinephrine should always be administered right away, as the drug can be less effective if a reaction has progressed.

On March 13, 2013, Maia Santarelli-Gallo, a 12-year-old girl from Burlington, Ontario (in Canada), appears to have experienced anaphylaxis during an outing to a shopping mall with her father and older sister. Local news reports suggest Maia had reacted to dairy and egg in the past, but her parents had been told she was intolerant rather than allergic, and she had never been prescribed an auto-injector. At this point, it is not definitively known what caused the reaction, but milk is suspected – since the last thing Maia ate was an ice cream cone.

Asked to comment on the girl’s fatal reaction, allergist Dr. Susan Waserman expressed profound concern to the local press. “It speaks to the need for proper diagnoses, proper education, how the family was told to handle this supposed food intolerance,” she said, adding that better support for the family would have led the girl to have an auto-injector. “The whole community feels terrible when we feel something like this,” she said.

On March 8, 2013, Cameron Groezinger-Fitzpatrick, a 19-year-old from Plymouth, Massachusetts, died from his peanut allergy while home from university for spring break. His family has said that a friend had offered him a cookie, which was supposed to be peanut-free but turned out to contain peanut butter.

According to ABC News, Cameron’s mother was told over the phone by a 911 operator not to administer an expired EpiPen which was in a nearby cupboard. Cameron’s current auto-injector couldn’t be found in time, as he had not finished unpacking for his visit.

“I didn’t know you can die from nut allergies. I feel foolish,” Robin Fitzpatrick, Cameron’s mother, told ABC News.

These tragic events reinforce the need for allergy education and having epinephrine always ready to access for those with food (and sting) allergies.

In more positive news, several states are beginning to see the importance of readily available epinephrine and are passing bills that allow doctors to prescribe “stock” auto-injectors to schools. These devices can used in emergencies for students who don’t have an auto-injector on school premises (in some cases, it may be a first allergic reaction).

Kentucky, Nevada, Oregon, Georgia and Tennessee have all seen recent progress in such bills in their state legislatures. In fact, Kentucky Governor Steve Beshear will be holding a formal ceremony to sign that state’ stock epinephrine bill into law on April 22, 2013.

• Intentional Food Allergy Exposures: Researchers have revealed the reasons that a concerning number of parents are knowingly giving their allergic children food that they are allergic to.
• Pollution Changing Genes: Researchers found that a certain type of air-pollution may be causing a DNA change which results in worsened asthma symptoms, and potentially even new cases of asthma.
• Milk Therapy Lacks Staying Power: Editor Gwen Smith on the study that showed a surprising reversal among patients who had been successfully treated for milk allergy.
• Alcohol, Asthma and Aspirin: A group of people with asthma are experiencing respiratory reactions when drinking alcohol. But how does Aspirin fit into the equation?
• Allergic Children Underweight: Children with multiple food allergies or milk allergy appear to be underweight when compared with their non-allergic peers.
• A New Spot for the Shot: Investigators discovered that there may be a more effective location for an epinephrine shot in obese patients.

Epinephrine works best when injected directly into muscle, as opposed to fat, as it absorbs into the bloodstream faster this way. Using ultrasound results, researchers from the U.K. measured the distance between the surface of the thigh and the inner muscle of 93 children. It was discovered that this distance was greater than the length of the auto-injector’s needle in 82 percent of the obese children studied.

At three-quarters down the thigh, the distance was reduced so that only 17 percent still had their muscle out of reach.  This suggests that the lower thigh could be a more effective location for giving an epinephrine shot to any obese individual.

Heights, weights, waistline measurements and body mass index data were gathered in order to determine which children would be considered obese.

See more news from the AAAAI 2013 conference here.