Over the past several weeks, we have received numerous inquiries about using epinephrine in patients with anaphylaxis. Specifically, our orders on our Anaphylaxis Treatment Plan, have been called into question. I think we need to take a few moments to reinforce what we have come to learn over the past several years regarding the treatment of anaphylaxis.
I want to be very clear on this first point — anaphylaxis kills! Let me repeat that, anaphylaxis can kill a person. Anaphylaxis is a true medical emergency that requires an immediate and swift response – i.e. the use of one’s auto injectable epinephrine. The literature has become very clear over the past few years on this topic: those that don’t use or wait to use their epinephrine potentially do not have good clinical outcomes; conversely, those who use their injectable epinephrine at the first signs of anaphylaxis generally do much better.
Epinephrine is THE LIFE SAVING DRUG to be used to treat patients with anaphylaxis. It is the drug that treats the underling pathophysiology of anaphylaxis. It is the drug that can potentially save your life. No other medication, oral antihistamines, bronchodilator medications or steroids, has been shown to save lives in anaphylaxis. These (antihistamines, bronchodilators or steroids) medications are important secondary medications that can potentially be used in patients experiencing anaphylaxis. My clinical experience and review of case reports in the literature invariably has revealed that the vast majority of those who have complicated courses or die from anaphylaxis either never were treated with epinephrine or did not receive epinephrine promptly. Sadly, there are those who do treat themselves promptly with auto injectable epinephrine and seek immediate care who will still die.
Anaphylaxis is a very serious medical condition. I do not want patients paralyzed by fear because they have anaphylaxis. Nor do I want them paralyzed with anxiety about using epinephrine during an episode of anaphylaxis. The potential risk of a bad outcome in anaphylaxis when epinephrine is not used or used too long after the reaction started far exceeds the risk of a bad outcome from using epinephrine promptly during an episode of anaphylaxis. So please, if you or your child is experiencing anaphylaxis, do not hesitate use auto injectable epinephrine and call 911.
If your or a loved one are concerned about anaphylaxis, the symptoms of anaphylaxis, how to treat anaphylaxis or worried about using auto injectable epinephrine, talk with your physician. Don’t wait until it is too late.