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ACAAI: EMS Personnel May Not Carry Epinephrine

Availability and use vary nationwide; many anaphylaxis patients do not use epinephrine

MONDAY, Nov. 9 (HealthDay News) -- The availability and use of epinephrine for anaphylaxis by emergency medical services (EMS) varies nationwide, and less than one-third of anaphylaxis patients prescribed self-injectable epinephrine use it prior to arrival at a hospital, according to research presented this week at the annual meeting of the American College of Allergy, Asthma & Immunology, held from Nov. 5 to 10 in Miami Beach, Fla.

In one study, Dana V. Wallace, M.D., a private practitioner in Fort Lauderdale, Fla., and colleagues surveyed 50 state EMS medical directors. They found that only 17 states require EMS-Basics to carry epinephrine, and that 15 states do not require any level of EMS to carry epinephrine. Lack of training, cost of auto-injectors, and legal concerns were cited as the main reasons why EMS do not carry epinephrine.

In a second study, Veena Manivannan, M.D., of the Mayo Clinic College of Medicine in Rochester, Minn., and colleagues studied 58 anaphylaxis patients who presented at an emergency department. Although most patients understood they were having a severe allergic reaction that required immediate medical attention, only 19 percent arrived at the hospital by ambulance and only 30.8 percent of those prescribed self-injectable epinephrine used it prior to arrival.

"Despite a reasonable level of awareness, there is still room for educational models to be implemented to expedite first aid and seek expert medical care for anaphylaxis," Manivannan and colleagues write.

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