Journal of Allergy and Clinical Immunology, Feb 1, 2017
RATIONALE: To compare the rate, triggers and management of anaphylaxis between adult emergency de... more RATIONALE: To compare the rate, triggers and management of anaphylaxis between adult emergency departments (ED) in Western and Eastern Canada. METHODS: As part of the Cross-Canada Anaphylaxis Registry (C-CARE), we conducted a chart review of adults presenting with allergyrelated ICD-10 codes to a tertiary care centre ED in Western Canada (Edmonton, Alberta) between March 1, 2011 and February 28, 2012. Anaphylaxis cases were defined as those that fulfilled the published consensus definition for anaphylaxis. Clinical and management data were collected and compared to published data from an ED in Eastern Canada (Montreal, Quebec). RESULTS: Among 59,195 presentations to the Edmonton ED, 0.22% (95% CI 0.19%, 0.27%) were due to anaphylaxis. Food was the trigger in 57.1% (48.3%, 65.7%), mainly tree nut (21.0% (12.5%, 31.9%) of foodtriggered cases). Epinephrine was used in 54.9% (46.0%, 63.5%) and 41.3% (32.9%, 50.2%) were prescribed an auto-injector. In Montreal, 0.26% (0.21%, 0.32%) of ED presentations were due to anaphylaxis, and 63.3% (52.9%, 72.6%) were triggered by food, primarily shellfish (12.9% (6.1%, 24.4%) of food-triggered cases). Epinephrine was used to treat 49.0% (38.8%, 59.2%) of patients and 67.1% (55.3%, 77.2%) were prescribed an auto-injector. CONCLUSIONS: In Western and Eastern Canada, anaphylaxis accounted for over 0.2% of adult ED visits and was mainly due to foods. Tree nuts rather than shellfish were the main food triggers in Western Canada. Given the poor adherence to guidelines stipulating epinephrine use in all anaphylaxis cases, education programs promoting early epinephrine use are required across the country.
Journal of Allergy and Clinical Immunology, Feb 1, 2017
RATIONALE: To compare the rate, triggers and management of anaphylaxis between adult emergency de... more RATIONALE: To compare the rate, triggers and management of anaphylaxis between adult emergency departments (ED) in Western and Eastern Canada. METHODS: As part of the Cross-Canada Anaphylaxis Registry (C-CARE), we conducted a chart review of adults presenting with allergyrelated ICD-10 codes to a tertiary care centre ED in Western Canada (Edmonton, Alberta) between March 1, 2011 and February 28, 2012. Anaphylaxis cases were defined as those that fulfilled the published consensus definition for anaphylaxis. Clinical and management data were collected and compared to published data from an ED in Eastern Canada (Montreal, Quebec). RESULTS: Among 59,195 presentations to the Edmonton ED, 0.22% (95% CI 0.19%, 0.27%) were due to anaphylaxis. Food was the trigger in 57.1% (48.3%, 65.7%), mainly tree nut (21.0% (12.5%, 31.9%) of foodtriggered cases). Epinephrine was used in 54.9% (46.0%, 63.5%) and 41.3% (32.9%, 50.2%) were prescribed an auto-injector. In Montreal, 0.26% (0.21%, 0.32%) of ED presentations were due to anaphylaxis, and 63.3% (52.9%, 72.6%) were triggered by food, primarily shellfish (12.9% (6.1%, 24.4%) of food-triggered cases). Epinephrine was used to treat 49.0% (38.8%, 59.2%) of patients and 67.1% (55.3%, 77.2%) were prescribed an auto-injector. CONCLUSIONS: In Western and Eastern Canada, anaphylaxis accounted for over 0.2% of adult ED visits and was mainly due to foods. Tree nuts rather than shellfish were the main food triggers in Western Canada. Given the poor adherence to guidelines stipulating epinephrine use in all anaphylaxis cases, education programs promoting early epinephrine use are required across the country.
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Papers by Elisa Alvarez