The Joint Task Force between the American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology have released two new guidelines for allergic reactions.
The new recommendations are that calling an ambulance after use of an epinephrine auto injector is not required if the patient experiences prompt and complete, and response to treatment. Paramedics should be called for severe anaphylaxis, symptoms that do not resolve promptly, or nearly completely, or symptoms that return or worsen.
The recommendation remains not to give epinephrine preemptively to an asymptomatic patient.
The panel also relieves some of the panic induced by the Mylan marketing department about expirations. Epinephrine is 80%-90% effective well beyond the expiration dates so if they are needed, an expired one is better than doing nothing at all.
They also hope to create a better universal definition because multiple triggers can lead to anaphylaxis, and having reliable predictors of anaphylaxis severity can help optimize treatment, but severity of reactions is influenced by many different factors related to the patient and the allergen. There are limitations to existing anaphylaxis severity scoring systems. The lack of the lack of a universal, standard, practical definition has contributed to both underdiagnosis in poorer areas and overdiagnosis in wealthy US states like California. The reason is most definitions of anaphylaxis include the word “generalized” and/or “systemic” reaction, which is subjective even in the medical community. For the people most likely to be there, such terms are useless.
