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BET 1. EPINEPHRINE SELF-INJECTION FOR ANAPHYLAXIS IN CHILDREN

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Report by Richard Body, Specialist Registrar in Emergency Medicine

Checked by Deepak Doshi, Specialist Registrar in Emergency Medicine

Institution: Manchester Royal Infirmary, Manchester, UK

A short cut review was carried out to establish whether there is any evidence in favour of epinephrine self-injection for anaphylactic reactions in children. Only three papers provided evidence related to the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are presented in table 1. The clinical bottom line is that although there are no clinical trials to answer the question there is other evidence to suggest that it can be effective.

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Table 1 Epinephrine self-injection for anaphylaxis in children

THREE-PART QUESTION

In [children with anaphylaxis] does [self-injection of epinephrine] lead to [reduced mortality and morbidity]?

CLINICAL SCENARIO

A 5-year-old boy is admitted with anaphylactic shock having inadvertently ingested peanuts at a birthday party. He had a previous reaction 2 years ago and was given an epinephrine auto-injector for use at home. His mother had used this when the …

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