Talk:Anaphylaxis

US Death Rate

The article includes "Currently, anaphylaxis leads to 500–1,000 deaths per year (2.4 per million) in the United States, 20 deaths per year in the United Kingdom (0.33 per million), and 15 deaths per year in Australia (0.64 per million)."

It seems odd that the rate in the US is seven time higher than in the UK. I have found this [1] that gives a much lower rate (0.86 per million) in a recent US study. MB 16:03, 13 July 2017 (UTC)

Per ths source "These results indicate that the US has one of the highest prevalences of fatal anaphylaxis in the world". Appears to be based on a 2010 study.

What we have in the article is based on this source [2] which is a peer reviewed review article.

Have added this estimate aswell.Doc James (talk · contribs · email) 20:56, 13 July 2017 (UTC)

Diagnosis, 2nd bullet

Hello James or Wakkie1379, you really think, that involvement of the skin or mucosa AND gastrointestinal symptoms together means anafylaxis? Urtica and diarrhea after strawberries? --DRobert (talk) 08:15, 28 May 2018 (UTC)

Not the editors' fault, this is straight from the first table in the WAO guidelines.[3]. JFW | T@lk 17:33, 28 May 2018 (UTC)

And your opinion is that's right? Only skin and intestinal problems? Iḿ only poor anesthesiologist :), but I call it allergy. OK, I will ask my histamine friends. Its bad formulation in guidelines, I'ḿ afraid.--DRobert (talk) 18:48, 29 May 2018 (UTC)

The bar for anaphylaxis has decreased over the years. Doc James (talk · contribs · email) 19:20, 29 May 2018 (UTC)

Preferred post-epipen medication?

To followup on a conversation that was archived while I was gone...

The prefered post epi med? That depends on the situation. If you still have significant symptoms the prefered post epi med is more IM epi. And then if you are not better it is more IM epi again. And then if you are still not better one might move to iv epi or if you are on beta blockers glucagon. You can thrown in some diphenydramine, ranitidine, and steroids but are not to fool yourself that these at any time replace epi. At least that is my reading of the literature. Doc James (talk · contribs · email) 07:43, 2 August 2016 (UTC)

So I believe the advice I got in my "advanced remote areas first aid training" was that Benadryl would indeed *follow* administration of Epipen medication. I guess that correlates with the current statement in the Benadryl page:

By injection it is often used in addition to epinephrine for anaphylaxis. Its use for this purpose had not been properly studied as of 2007. Its use is only recommended once acute symptoms have improved.

The situation(s) I am expecting (but obviously not hoping for) are when I travel in a remote area without access to proper medical facilities. IV, extra epi, any assistance is out of the question. The best case scenario is that the allergic person was smart enough to bring *one* epipen, but considering evacuation might take hours, I want to be able to keep the person stable in the long term. My understanding of the Epipen is that it lasts long enough to bring the patient to the hospital for further treatment, which is often impossible (in the short term) in the situations I end up with. My hope is that Benadryl pills might provide the necessary stabilization until we evacuate properly. But maybe that's naïve? In any case, I guess I should talk this over the counter with my pharmacist instead of asking Wikipedia. ;) Thanks for the references anyways, the drugs.com and literature review are especially interesting: from what I understand, they "neither confirm nor deny" the practice, but it's still a commonly used pattern to treat severe allergic reactions... --TheAnarcat (talk) 20:34, 6 July 2019 (UTC)