New Study Shows Many Still Unsure How To Recognize And Manage Allergic Reactions

Anaphylaxis is a severe, potentially life-threatening allergic reaction that can occur within minutes of exposure to an allergen, even in trace amounts, like eggs or peanuts. However, recent studies show that many people with allergies, and those who care for them, often lack the knowledge to act quickly and effectively when anaphylaxis strikes.

Two new studies, presented at the American College of Allergy, Asthma, and Immunology (ACAAI) annual meeting in Boston, highlighted the widespread confusion surrounding the recognition and treatment of anaphylaxis. One study focused on patients’ awareness of anaphylactic symptoms and how to respond, while the other examined the inconsistencies in emergency medical services (EMS) protocols across different US states.

The first study, led by Dr Sasha Alvarado, co-director of quality and safety for the Division of Immunology, Allergy, and Retrovirology at Baylor College of Medicine, surveyed 96 allergy patients and caregivers. Alvarado’s team found that while most respondents (73 per cent) felt “comfortable” identifying anaphylaxis symptoms, only 14 per cent would likely use epinephrine as a first-line treatment if an allergic reaction occurred. Epinephrine, the active ingredient in EpiPen, is the recommended rescue medication for anaphylaxis, but various factors contributed to patients’ reluctance to use it.

According to the survey, reasons for hesitation included uncertainty about which symptoms warranted treatment (41 per cent), reluctance to visit the emergency room (24 per cent), and hesitation to call 911 (18 per cent). Some respondents were also unsure how to use the auto-injector (12 per cent) or had a fear of needles (5 per cent). Alvarado emphasized the critical role of early recognition and treatment with epinephrine, as timely administration can significantly improve outcomes. “These results show the need for better education among allergy patients to recognize and treat anaphylaxis promptly,” Alvarado noted.

The second study, led by Dr Carly Gunderson from Memorial Healthcare System in Fort Lauderdale, Florida, analyzed EMS protocols for managing anaphylaxis across 30 states. Gunderson’s research revealed significant variations in the definition of anaphylaxis and the recommended treatment approach. Only half of the states included gastrointestinal symptoms as part of the anaphylaxis criteria, and just 40 per cent recognized neurological symptoms as indicators, reflecting inconsistencies in defining the condition.

In terms of treatment, nearly all states (97 per cent) listed epinephrine as the primary intervention for anaphylaxis. However, only 57 per cent provided epinephrine auto-injectors to EMS personnel, despite the devices’ convenience and effectiveness. “Many EMS anaphylaxis protocols are incomplete and/or outdated,” Gunderson observed, noting that inconsistencies were evident in medication recommendations as well. 90 per cent of states advised using albuterol if respiratory symptoms appeared, while 73 per cent recommended intravenous fluids, and 60 per cent suggested steroids, although the latter is now considered outdated for anaphylaxis management.

The discrepancies in EMS protocols reveal a need for standardization across state guidelines, ensuring patients receive consistent and effective care. The findings, though preliminary until published in a peer-reviewed journal, underscore the urgent need for enhanced training and uniform protocols for both patients and emergency responders when it comes to anaphylaxis management.

These studies show the importance of clear, up-to-date guidelines and education for managing anaphylaxis, as prompt treatment can be life-saving. For patients, caregivers, and healthcare providers, understanding and correctly responding to allergic reactions are crucial in preventing severe complications.

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