In a new article published in the Annals of of Allergy, Asthma and Immunology, experts recommend the use of epinephrine for all severe allergic reactions, even for patients at risk of an anaphylactic reaction.

The panel of allergists and emergency physicians discuss barriers to emergency care for anaphylaxis and ways to encourage appropriate treatment. Stanley Fineman, MD, American College of Allergy, Asthma & Immunology (ACAAI) past president, and panel chair, said that epinephrine should be used even if a patient’s reaction may not “meet all the established criteria” for anaphylaxis. The panel also concluded that epinephrine should be administered to patients at risk of an anaphylactic reaction based on a previous severe reaction or those who have had a known or suspected exposure to their allergic trigger with or without the development of symptoms.

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Experts urge that epinephrine not be substituted with antihistamines or corticosteroids because they do not work fast enough. They also added that any patient seen for anaphylaxis in the emergency room should be referred to an allergist to schedule a follow-up visit.

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