Anaphylaxis accounts for a substantial proportion of the cases managed by paramedics in Outaouais, Quebec, new Canadian research reveals.
Among 23,486 ambulance calls requiring transportation to hospital over a 12-month period in the Outaouis region, 104 cases or 0.44% were identified as anaphylaxis, according to the study, published in July 2015 in Immunity, Inflammation and Disease.
This proportion is higher than in Quebec emergency rooms, according to Dr. Moshe Ben-Shoshan, a pediatric allergist at the Montreal Children’s Hospital and lead author of the AllerGen-funded study.
“The percentage of anaphylaxis was higher in the emergency medical services (EMS) calls requiring transportation as compared to our findings for anaphylaxis visits in both pediatric (0.21%) and adult (0.26%) emergency departments,” says Dr. Ben-Shoshan. “This is not surprising, given that the EMS manages acute cases requiring prompt lifesaving intervention and the emergency department may treat cases that are not considered life-threatening.”
The study also found that epinephrine was not administered in 35.6% of the ambulance call cases, and among patients with a known food allergy, only 50% used their epinephrine auto-injector prior to ambulance arrival.
“This is concerning, given that more than a third of the anaphylaxis cases were severe, with food, mainly peanut, as the main trigger,” says Dr. Ben-Shoshan. “Training and educational programs targeting paramedics and patients with a known food allergy are critical to ensure the prompt use of epinephrine for anaphylaxis.”
The study, “Anaphylaxis in the pre-hospital setting,” is part of AllerGen’s Cross-Canada Anaphylaxis Registry (C-CARE) project. C-CARE, the first-ever prospective study on anaphylaxis, is helping researchers to assess the rate, triggers and management of anaphylaxis in different settings across Canada.