ANAPHYLAXIS ANXIETY

When should you really use that epinephrine injection?

Click here for previous newsletters.

1. Counselling Conundrum: a real question from a patient

2. Concise Conclusion: a straight-forward patient-friendly answer 

3. Quick Wrap-up 

Clearly, there are nuances that may not be captured in this format. The goal here is to provide you with helpful counselling tips which often draw from multiple sources or those which are not commonly accessed by busy healthcare providers serving the community.

Counselling Conundrum: "How do I know when I should use my EpiPen? If I have a mild rash, should I still use it?"

Concise Conclusion: This is a great question, and the instructions on the EpiPen don't even answer it very well. First, if you're ever in doubt, it's generally better to use it rather than to risk a severe allergic reaction. But, as a general rule, if two or more different bodily systems are affected (e.g. skin [rash/itching/flushing], breathing [e.g. shortness of breath/wheezing/cough], low blood pressure [e.g. collapse/fainting], gut issues [e.g. cramping/vomiting]), this is when it's advised to use it. Remember, always dial 911 after you use any epinephrine.

Quick Wrap-up: The take-home here is to use it if you're concerned about anaphylaxis, not to have a specific clinical cut-off. However, it's important patients know the general shape of anaphylaxis. We also like to remind patients that expired epinephrine is always better than none.

Dive Deeper

1) Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis - PubMed (nih.gov)

2) Signs-and-symptoms-of-anaphylaxis.pdf (foodallergycanada.ca)

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