Patient/parent administered epinephrine in acute anaphylaxis

Area of Science:

• Allergy and Immunology
• Emergency Medicine
• Public Health

Background:

• Peanut allergy is common, yet epinephrine auto-injector (EAI) carrying and usage rates during anaphylaxis are low.
• Previous studies indicate patient hesitancy in self-administering epinephrine during allergic emergencies.

Purpose of the Study:

• To determine the on-scene usage rates of epinephrine auto-injectors (EAIs) among patients experiencing anaphylaxis.
• To identify factors influencing the on-scene administration of epinephrine by patients and healthcare professionals.

Main Methods:

• Retrospective review of electronic medical records for 217 patients diagnosed with peanut anaphylaxis or anaphylaxis with a known epinephrine prescription.
• Analysis of physician notes and demographic data from 2010 to May 2020.

Main Results:

• On-scene epinephrine administration occurred in 25.3% of anaphylaxis patients.
• Healthcare professionals administered epinephrine on-scene 100% of the time.
• Females (32.2%) used EAIs more than males (19.8%); administration rates increased from 2010-2019.

Conclusions:

• A low EAI administration rate (22.6%) among non-healthcare professionals suggests underutilization even when prescribed.
• Healthcare professionals' 100% administration rate indicates comfort and training are key facilitators.
• Physicians should promote EAI training devices and strategies due to high EAI costs and low patient usage.