Adrenaline and anaphylaxis: could we inject it better?

#Anaphylaxis #Allergy #Adrenaline #AAI  


Anaphylaxis is a rapid-onset, potentially fatal systemic hypersensitivity reaction triggered by allergens such as foods (peanuts, tree nuts, shellfish, milk, egg), drugs, or insect venoms. Symptoms can appear within seconds and progress to airway obstruction or cardiovascular collapse.  

Although intramuscular (IM) adrenaline is the first-line treatment recommended by scientific societies, its use remains insufficient, often delayed, and marred by dosing or route-of-administration errors. Antihistamines and corticosteroids are only second- or third-line treatments and have no effect on the immediate life-threatening symptoms. Rapid recognition of anaphylaxis is also challenging, especially in children and infants. Barriers include under-prescription of adrenaline auto-injectors (AAIs), fear of adverse effects, lack of training for patients and healthcare providers, and limited AAI availability in some countries.