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Product info for epipen here (aust) is 25kg for junior but all allergist prescribe adult one at 20kg based on current research in management of anaphylaxis.
My son was switched to adult epi last year, age 7 and barely 50 lbs.
Also, she told me that it is time to get Epi, rather than Epi Jr., but the packaging says 65 pounds for Epi, and my daughter is only 44 !
But the Benadryl is what is used for long term treatment to stop the histamine dump and keep the anaphylaxis from continuing.
Antihistamine is a useful medication for some relief of symptoms such as a few hives, but has no capacity whatsoever to prevent or control more serious allergic reactions. If a reaction is going to progress, the administration of Benadryl will not help to prevent any real progression.
In Canada’s guidelines, we don’t support the use of Benadryl if symptoms are developing in response to the accidental ingestion of food. However, some allergists will disagree with me.
But the other thing you have to remember is that only 100 people or so die every year from food allergy anaphylaxis. It's rare. Yes, it's good to be safe than sorry, but part of living life is risk. You can die from walking across the street but it doesn't stop you from taking the chance.
"If food allergy deaths in food-allergic individuals are rare, do we change our ways?"
[url]http://foodallergysleuth.blogspot.com/2013/12/if-food-allergy-deaths-in-food-allergic.html[/url]QuoteThe study authors certainly have noble intentions of this study reducing the anxiety faced by food allergic individuals or their caregivers.
"FOOD ALLERGY: A LOT IS RIDING ON OUR TIRES"
[url]http://www.allergyhome.org/blogger/food-allergy-a-lot-is-riding-on-our-tires/[/url]QuoteFor me, their findings convey the unlikelihood of a fatal anaphylactic reaction if appropriate management strategies are implemented, and provide me with some reassurance.
(FWIW, I liked the way he framed this.)
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Also, ana itself does not appear to be rare:
"ANAPHYLAXIS IN AMERICA"
[url]http://www.aafa.org/display.cfm?id=6&sub=110&cont=882[/url]QuoteAccording to the peer-reviewed study, anaphylaxis very likely occurs in nearly 1-in-50 Americans (1.6%), and the rate is probably higher, close to 1-in-20 (5.1%).
The reason why there are so many different types of treatments given are because most parents are extremely cautious (which is fine by me) but the first sign of their kid with a red bump and they are reaching for the epi-pen. What parents need to do is learn how to watch their kids for signs of progression rather than giving their kid an injection any time they sneeze.
I know some people adhere to the "better safe than sorry" guidelines, but if you are quick to act when you see their status deteriorating, then you will never be sorry. The key is to read, watch somebody for signs of progressions and more importantly keep a calm head.
The reason why there are so many different types of treatments given are because most parents are extremely cautious (which is fine by me) but the first sign of their kid with a red bump and they are reaching for the epi-pen. What parents need to do is learn how to watch their kids for signs of progression rather than giving their kid an injection any time they sneeze.
Dr. Jacobsen's team surveyed 3500 nationally registered paramedics in the United States and found that 36.2% of responders felt there were contraindications to the administration of epinephrine for a patient in anaphylactic shock.
"They also had challenges in the recognition of atypical presentations of anaphylaxis and determining the correct location and route of epinephrine administration," he said.
Only 2.9% correctly identified the atypical presentation, 46.2% identified epinephrine as the initial drug of choice, 38.9% chose the intramuscular route of administration, and 60.6% identified the deltoid as the preferred location (11.6% identified the thigh).
We have the same issues in the United States that were found in the Canadian study.
"Our study also revealed that 40% of paramedics believed that diphenhydramine was the first-line medication for a patient suffering from anaphylactic shock," added Dr. Jacobsen.
I'm printing John's posts out for the next appointment with allergist showing in the words of an EMT what he thinks of the EAP, carrying and administration of epinephrine. Then I'll finally get that letter on practice letterhead from allergist to give to EMTs I've been asking about. He didn't believe me that rift between allergist and EMT exists. Got proof now!
The big change in claim from being an EMT who is pushing for the importance of Benadryl to someone trying to convince us that we are epiing too much and that the epi isn't needed as the risk of not doing so is remote also made me think troll but who knows.
Somebody mentioned loony earlier and I wouldn't be so quick to discount that. Just because you keep jabbing your kid with an Epi-Pen it doesn't mean that you are keeping them safe. Did your allergist also talk with you about the risks involved? Oh wait let me guess, the risks outweigh the potential for death right?
{snip}
I'm sure his/her heart will be in great condition once they reach 21 from dosing on Epi-Pen 52 times a year.
I've already inserted a number of those same links, Mac! :thumbsup:
We do get trolls, folks. Yes we do. ;)
Of course, it's only term break right now for college and high school students on SEMESTERS. So expect more of this sort of thing come the quarter-break in March. LOL.
but the first sign of their kid with a red bump and they are reaching for the epi-pen
John-- PLEASE consider carefully reading the following:
[url]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096462/[/url]
Why not antihistamines or corticosteroids first?
There is no evidence that they provide life-saving treatment (i.e. they do not prevent or relieve upper airway obstruction, hypotension, or shock).[24] Antihistamines [IM or intravenous (IV)] are adjunctive therapies and may be tried after epinephrine is administered to help control cutaneous and cardiovascular manifestations, such as itching, flushing, urticaria, angioedema, and nasal and eye symptoms, as well as prevent secondary reactions.
Limited awareness of the treatment of anaphylaxis by health professionals
Data from several cohort studies illustrate the extent of under-treatment of anaphylaxis and the low rate of adrenaline use [12, 15, 39-41], with most cases of anaphylaxis that require hospitalization not receiving an AAI on discharge. Adrenaline is much less commonly used than antihistamines and corticosteroids in treating anaphylaxis despite both antihistamines [42] and corticosteroids [43, 44] having an onset of action that is delayed and too late to prevent respiratory and/or cardiovascular arrest, which can occur within minutes [23].
Antihistamines will never ever ever stop a severe anaphylaxis reaction from progressing. The right thing to do is, as early as possible with one of these episodes, is to use your epinephrine auto-injector