Food Allergy and Why Two Doses of Epinephrine May Be Necessary

A recent study reported in the Journal of Pediatrics determined the need for people with food allergies to carry multiple doses of epinephrine.The study followed 605 children (median age 5.8) to find out how many of them needed a second dose of life-saving medication after suffering a food related allergic reaction. Twelve percent of patients needed the second dose, causing the researchers to support the recommendation of carrying two doses of self-injectable epinephrine.

Now, 12% doesn't seem like a high number to me, but how are you to know if you or your child require that second dose? At this point my child carries one epi to school. A second one is in the nurse's office. When traveling, we carry multiple epis and there are several in our house.

For those interested in two dose medications, Twinject® offers a back-up dose. Their site suggests that 20% of reactions require a second dose. Since both doses are in one pen, the Twinject can be used in a single with carrying pouch. Our allergist has always prescribed the Epi Pen®, but I plan to discuss other options.

It's on the list...

What brand of epi do you use? How many pens do you have?

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Allergy Medication: The EpiKey

Epipens® and Twinjects® are a wonderful medical device that save lives of those experiencing an anaphylactic reaction due to food, insect sting or latex allergy. I also find them to be bulky and I worry about my child carrying the medicine as a teen and young adult. It turns out someone else was worried about that too. TCB Medical Devices has developed the EpiKey, a small epinephrine device that fits on a key chain.

The EpiKey was created by Thomas C. Beller, MD., an allergist in South Carolina. Dr. Beller hopes this device will save lives with its small size and ease of use. It's on a fast-track for FDA approval.


I'll keep you posted.

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New Food Allergy Studies

The American College of Allergy, Asthma and Immunology has just wrapped up their annual conference. Many studies related to food allergy were presented at the conference. Here are some interesting highlights:

"Use of Epinephrine for the Treatment of Anaphylaxis by US Emergency Medical Service(EMS)Personnel in the Pre-Hospital Setting"- Only 17 states require EMS-Basics to have epinephrine available, and 15 states do not require any level of EMS to carry epinephrine for anaphylaxis treatment.


"Proactive Egg Ingestion in High-risk Patients with Severe Egg Allergy" Twenty-nine severely egg allergic patients were introduced to egg in carefully controlled increments. Eighty-six percent were able to eat one fourth of cooked whole egg within 10 months.

"What Does a Patient with Anaphylaxis Do before Seeking Medical Attention?" Many people delay medical treatment of a food allergy reaction because they believe the symptoms will subside over time. Of those who sought medical care for a reaction, only 30% used self-injectable epinephrine prior to arrival for treatment. This study concluded that more education is needed as time is critical when treating an allergic reaction.

"The School Nurse's Perception of Food Allergy - A Statewide Survey" A survey conducted in Mississippi revealed that students were more likely to have food allergy action plans if the school nurse received information on food allergies from parents or a physician, or if the student attended a school in an urban area. The study showed that 97% of the nurses surveyed had at least one child with food allergy in the school. Only 30% of schools had action plans for children with food allergy.

Want more detail on any of these highlights? Read the summaries here.

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