Two recent studies presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Boston reveal significant misunderstandings in the management of anaphylaxis among patients, caregivers, and emergency medical personnel. Anaphylaxis is a severe allergic reaction that can be life-threatening if not treated promptly with epinephrine.
Sasha Alvarado, DO, from Baylor College of Medicine, emphasized the importance of early recognition and treatment with epinephrine to improve outcomes. Joni Chow, DO, a Pediatric Resident at Baylor College of Medicine in San Antonio and lead author of one study, stated that their survey "demonstrates the need for better education of allergy patients to recognize and treat anaphylaxis appropriately."
The survey conducted by Chow's team involved 96 patients and caregivers in an allergy clinic waiting room. Despite 95% being prescribed epinephrine and 73% feeling comfortable recognizing symptoms, only 14% were likely to use epinephrine first. Barriers included uncertainty about symptoms (40.6%), reluctance to visit the emergency room (24%), hesitation to call 911 (17.7%), lack of knowledge on using auto-injectors (11.5%), and fear of needles (5.2%).
Another study analyzed state-wide protocols for emergency medical services (EMS) across the United States regarding prehospital treatment of anaphylaxis. Carly Gunderson, DO, lead author of this study noted discrepancies such as variations in defining anaphylaxis and treatment methods. "Many EMS anaphylaxis protocols are incomplete and/or outdated," she said.
The analysis showed that only half of the states included gastrointestinal symptoms as part of anaphylaxis definitions while less than half considered neurologic manifestations. All states recommended diphenhydramine and epinephrine; however, only 97% prioritized epinephrine as the first line treatment.
Both studies highlight gaps in understanding and protocol standardization that could affect patient care during severe allergic reactions.
