Imperial College London
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Dr Paul Turner

Faculty of Medicine, National Heart & Lung Institute

Reader in Paediatric Allergy & Clinical Immunology
 
 
 
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Contact

 

+44 (0)20 3312 7754p.turner

 
 
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Location

 

Children's Clinical Research FacilityCambridge WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Dribin:2023:10.1016/j.jaip.2023.02.002,
author = {Dribin, TE and Waserman, S and Turner, P},
doi = {10.1016/j.jaip.2023.02.002},
journal = {Journal of Allergy and Clinical Immunology: In Practice},
pages = {1036--1046},
title = {Who needs epinephrine? Anaphylaxis, auto-injectors, and parachutes},
url = {http://dx.doi.org/10.1016/j.jaip.2023.02.002},
volume = {11},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - International guidelines stipulate that intramuscular (IM) epinephrine (adrenaline) is the first-line treatment for anaphylaxis, with an established good safety profile. The availability of epinephrine autoinjectors (EAI) has greatly facilitated the lay administration of IM epinephrine in community settings. However, key areas of uncertainty remain around epinephrine usage. These include variations in prescribing EAI, what symptoms should prompt epinephrine administration, whether emergency medical services (EMS) need to be contacted after administration, and whether epinephrine administered via EAI reduces mortality from anaphylaxis or improves quality of life measures. We provide a balanced commentary on these issues. There is increasing recognition that a poor response to epinephrine, particularly after 2 doses, is a useful marker of severity and the need for urgent escalation. It is likely that patients who respond to a single epinephrine dose do not require EMS activation or emergency department transfer, but data are needed to demonstrate the safety of this approach. Lastly, patients at risk of anaphylaxis must be counseled against over-reliance on EAI alone.
AU  - Dribin,TE
AU  - Waserman,S
AU  - Turner,P
DO  - 10.1016/j.jaip.2023.02.002
EP  - 1046
PY  - 2023///
SN  - 2213-2198
SP  - 1036
TI  - Who needs epinephrine? Anaphylaxis, auto-injectors, and parachutes
T2  - Journal of Allergy and Clinical Immunology: In Practice
UR  - http://dx.doi.org/10.1016/j.jaip.2023.02.002
UR  - https://www.sciencedirect.com/science/article/pii/S2213219823001782
UR  - http://hdl.handle.net/10044/1/103162
VL  - 11
ER  -
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