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RESEARCH AND BRIEFINGS

Managing Anaphylaxis

 


It’s hard to avoid the tragic headline news stories of young children who have died from anaphylactic and allergic reactions. Recently, a 12-year-old girl in Ontario died of an anaphylactic reaction after eating ice cream at the local mall. Sadly, her story is not unique to Ontario or Canada — with similar tragedies happening regularly around the world.

Anaphylactic reactions are often the result of underlying causes or new exposures that may not have triggered a reaction in the past. In an effort to reduce the number of deaths from anaphylaxis, organizations, public venues, and recreational facilities should conduct a risk-benefit analysis of housing Epi-Pen® and/or Twin-Ject® epinephrine on site to help manage the symptoms of anaphylaxis.

Background

According to the most recent statistics, more than 600,000 Canadians (1-2% of the entire population) are considered to be at risk for anaphylaxis, the increase due to rising rates of allergies in children.1

Those suffering from a severe food allergy are limited in what foods can or can’t be consumed, requiring increased vigilance to ensure that foods prepared outside the home are not cross-contaminated with potentially life-threatening ingredients. While living with food allergies is tough for most adults, it is significantly more challenging for children and adolescents.

Sabrina Shannon was one of those children. The Ontario teen suffered from multiple food allergies and was limited in what she could and could not eat. Despite her knowledge, keen judgment, and careful preparedness, Sabrina suffered an anaphylactic reaction to a trace amount of a dairy protein that was caused by cross contamination in her school cafeteria.

Following her tragic death, the Province of Ontario passed Sabrina’s Law (Bill 3) which requires all schools to have a comprehensive anaphylaxis policy, and to implement strategies to reduce the risks and exposures. Further recommendations include the use of appropriate signage, as well as management, education, and training in Epi-Pen® and/or Twin-Ject® use, and having epinepherine on hand to administer in the event of an emergency.2 Most notably, Sabrina’s Law also provides immunity to laypersons administering medications in an event of an emergency (unless there is gross negligence), provided that the act is undertaken in good faith and in response to an emergency situation.

What is Anaphylaxis?

Anaphylaxis is a potentially life threatening condition in which individuals’ bodies can activate an immune system response to a potential allergen. These reactions can range in severity: from a mild rash to a more severe respiratory compromise, and — if unrecognized and untreated — even death. This results from an exaggerated response to an otherwise benign exposure (such as food) to which the individual may (or may not) have launched a similar reaction in the past. There is no way of determining the potential of a fatal anaphylactic reaction versus a mild one.