Risks of using epinephrine too early

[lakeswimr]

The frustrating part is that there is a general consensus around the National Institute of Health's guidelines on how to treat anaphylaxis among most allergists in the USA but these guidelines are not making it to critical places which include to all allergists, pediatricians, general practitioners, and ER doctors and nurses in particular.  Our allergist had to call and educate the local ER doctor who argued with me even when I showed her our emergency plan and lectured me on having given the epi without "extreme breathing trouble".  She thankfully listened to the allergist and promised to educate the rest of the ER staff. 

Another area that should do better in this are medical schools.  Why is the treatment of ana not being taught well enough there?  Likewise, paramedic training programs, nursing programs, etc. 

Years ago FAAN started a program to educate ERs and spent money to do this after studies showed that most were not handling ana properly.  Years later other studies showed the same.  Hopefully there was some improvement from the efforts of FAAN but it is still a big problem.  And more so in the UK, apparently, where doctors seem to try to avoid the epi actively for some strange reason. 

People die as a result of this and that's what makes it such a big deal.  Most all fatality stories involve doctors who didn't educate their patients about the risks of food allergies well enough for them to know certain behaviors are not safe and also not well enough in how to recognize and treat anaphylaxis.  Mistakes can happen.  That's what makes people stressed.  But avoidable mistakes due to lack of education from doctors is infuriating.  Doctors perpetuating incorrect information is even worse. 

I see it as largely a problem of good information getting to the right places.

There are some who would say individual compliance with good information is the bigger issue but I think the first is more of the problem.

[CMdeux]

^ Definitely.


Though to be fair, at this point, I'd settle for a stoppage of the general flow of  the variety of mis-information illustrated by the link in the first post, even if better-informed isn't on offer, so to speak.

:/ 

I mean--  baby steps, right?

[Mr. Barlow]

The research focus on anxiety needs to be euthanized.  It is a dead end with no new salient or novel insights that would translate into meaningful patient benefit.  All it offers is a preferred task for clinicians, easy publications on a vulnerable populations.  Op-eds on allergies get all the attention anyway, and editors know this.   

I'm not on the OIT evangelism train, but even I can recognize that en masse a good portion of those grouped together by bad clinical advice (introduce late, overuse of IgE panels by peds) simply moved on into private practice OIT leaving vocal clinicans stuck on patient anxiety and 'helicopter parents' to sound off in their echo chamber.  Going back to lakeswimr for a moment, her intent may have been to emphasize that there is PLENTY for clinician researchers in allergy to move on now that would result in tangible policy effects by implementing uniform care between clinic and urgent care.

So, all this focus on patient anxiety is an easy task compared to turning efforts inward on the disparities in the continuum of care within the larger industry umbrella.  EMTs come under the Department of Transportation, as do air carriers.  That is clearly as removed from the allergist's office as can be.