Improving emergency department protocols, expanding knowledge of anaphylaxis and biphasic reactions, and enhancing training for emergency medical technicians (EMTs) to enable them to administer epinephrine are among the primary recommendations that will be made as a result of a recent Emergency Management of Anaphylaxis Summit organized by Food Allergy Research & Education (FARE).
Earlier this month, FARE convened representatives from two dozen leading organizations, institutions and medical facilities for the Emergency Management of Anaphylaxis Summit in Chicago. Attendees included food allergy experts, emergency physicians, paramedics and EMTs, emergency medicine educators, policymakers and advocates.
“Attendees at our Emergency Management of Anaphylaxis Summit were dedicated to a common goal – helping to ensure that individuals experiencing serious allergic reactions receive top-level emergency care from medical professionals who are equipped with the best, most up-to-date information to treat anaphylaxis,” said James R. Baker Jr., MD, interim CEO of FARE. “We are pleased to be working with the emergency medical community – and to have their enthusiastic support – to address key areas that can improve patients’ experiences and outcomes.”
The results of the summit include recommendations that address understanding of anaphylaxis among those at risk and the general public, as well as recognition and treatment of anaphylaxis by pre-hospital and emergency department personnel. Specific recommendations from the summit that FARE and participating organizations will continue to work on include:
- Creating a common description of anaphylaxis that may be used by healthcare professionals and patients for prompt and accurate diagnosis and treatment of anaphylaxis (including atypical presentations and biphasic reactions),
- Facilitating partnerships with organizations representing the continuum of emergency care in order to improve recognition, treatment and long-term management of anaphylaxis,
- Increasing usage of epinephrine, improving awareness of its first-line use in the management of anaphylaxis, and dispelling fears about contraindications and side effects,
- Working with policymakers at every level to allow all EMTs to carry and administer stock epinephrine and
- Improving emergency department discharge protocols so that patients, particularly those with first-time reactions, are better informed about how to manage the ongoing risk of severe allergic reactions and anaphylaxis. Results of a recent FARE survey showed less than a quarter of respondents were given information about food allergies, referral to an allergist or a prescription for an epinephrine auto-injector upon discharge from the emergency department.
“The summit convened by FARE was an unprecedented opportunity for those of us in emergency medicine to have a robust and valuable exchange with food allergy experts, allergists and parents about anaphylaxis and how it is treated,” said Michael Millin, MD, MPH, of Johns Hopkins University School of Medicine in Baltimore. “All attendees learned that there are ways to improve upon the training and work we are already doing, and that there are excellent resources, such as FARE, with whom we can partner to do so. I am excited to take back what I learned to my colleagues and also to continue working toward the goals expressed at the summit.”
FARE will create an action plan that will address the recommendations above and engage multiple stakeholders. Many of the organizations represented at the summit will contribute toward the development and implementation of this action plan. Summit attendees were as follows:
- Julie Brown, MDCM, MPH, Seattle Children’s Hospital, University of Washington
- Chris Cebollero, National Association of Emergency Medical Technicians
- Sunday Clark, ScD, Weill Cornell Medical College (New York. NY)
- Christopher Edwards, PharmD, BCPS, University of Arizona Medical Center (Tucson, AZ)
- Dia Gainor, National Association of State EMS Officials (Falls Church, Va.)
- Jeffrey M. Goodloe, MD, NRP, FACEP, University of Oklahoma School of Community Medicine, Office of the Medical Director, Medical Control Board, EMS System for Metropolitan Oklahoma City and Tulsa, Oklahoma
- Ruchi Gupta, MD, MPH, Northwestern University Feinberg School of Medicine, Lurie Children’s Hospital (Chicago)
- Thomas Hardin, Cook County Department of Homeland Security and Emergency Management (Chicago)
- Brian LaCroix, National EMS Management Association (Minneapolis)
- Sangil Lee, MD, FAAFP, FACEP, Mayo Clinic Health System (Mankato, Minn.)
- N. Clay Mann, PhD, MS, University of Utah School of Medicine (Salt Lake City)
- Michael Miller, EdD, RN, NRP, National Association of EMS Educators (Omaha, Neb.)
- Michael Millin, MD, MPH, Johns Hopkins University School of Medicine (Baltimore)
- Jill Mindlin, JD, Food Allergy Support and Education Group (Port Washington, NY)
- Kelly Morgan, Washington FEAST (Seattle)
- Nona Narvaez, Anaphylaxis & Food Allergy Association of Minnesota (St. Paul)
- Jon Nolan, King County Public Health Emergency Medical Services (Seattle)
- Maeve O’Connor, FAAAI, FACAAI, FACP, Allergy, Asthma and Immunology Relief of Charlotte (Charlotte, NC)
- Catherine Olson, MSN, RN, Emergency Nurses Association (Chicago)
- Gabriel Romero, National Registry of Emergency Medical Technicians (Columbus, Ohio)
- Scott Russell, MD, FAAP, FACEP, Medical University of South Carolina (Charleston)
- Hemant Sharma, MD, MHS, Children’s National Health System (Washington, DC)
- Cynthia Singh, MS, American College of Emergency Physicians (Irving, Texas)
- Rebecca Steinmann, APN, CCNS, Emergency Nurses Association (Chicago)
- David K. Tan, MD, EMT-T, FAAEM, National Association of EMS Physicians (St. Louis)
- Anne Thompson, Mothers of Children Having Allergies (Wilmette, Ill.)
- Dana Wallace, MD, Florida Center for Asthma and Allergy Care (Fort Lauderdale, Fla.)
- Arlo Weltge, MD, American College of Emergency Physicians (Houston)
- Joseph Wood, MD, Mayo Clinic (Scottsdale, Ariz.)
The summit was made possible by a sponsorship from Mylan Specialty L.P.
For more information about FARE, visit www.foodallergy.org.
Food Allergy Research & Education (FARE) works on behalf of the 15 million Americans with food allergies, including all those at risk for life-threatening anaphylaxis. This potentially deadly disease affects 1 in every 13 children in the U.S. – or roughly two in every classroom. FARE’s mission is to find a cure for food allergies, and to keep individuals safe and included. We do this by investing in world-class research that advances treatment and understanding of the disease, providing evidence-based education and resources, undertaking advocacy at all levels of government and increasing awareness of food allergy as a serious public health issue. For more information, please visit www.foodallergy.org and find us on [email protected], Facebook, YouTube and Pinterest.