Investigation of the underuse of adrenaline (epinephrine) and prognosis among patients with anaphylaxis at emergency department admission

Background Anaphylaxis is a potentially fatal condition; in severe cases of anaphylaxis, the cardiovascular system often heavily involved. Adrenaline (epinephrine) cornerstone initial treatment anaphylaxis. The use epinephrine remains below expectations clinical practice. Whether underuse affects prognosis patients with anaphylaxis still unclear. Materials and methods This retrospective study included between 2011 2020 who were admitted to an emergency department (ED) Taiwan. All divided into two groups based on (or not), we compared demographic characteristics, allergens, manifestations, management, patient outcomes. Results We reviewed records 314 subjects (216 males, 98 females; mean age: 52.78 ± 16.02 years) visited our ED due anaphylaxis; 107 (34.1%) 207 (65.9%) categorized group non-epinephrine group, respectively. Arrival via ambulance ( p = 0.019), hypotension 0.002), airway compromise < 0.001) altered consciousness deciding factors for among anaphylactic ED. had higher rates other inotropic agent usage fluid challenge. More than 90% received bed rest, steroids, antihistamines, monitoring. longer length stay (387.64 374.71 vs. 313.06 238.99 min, 0.03) greater need hospitalization. Among all symptoms, was most tolerated decision factor not using epinephrine. In this analysis, some serious did experience adverse outcomes or death even without at admission. Emergent care focuses first airway, breathing, circulation (ABC) may compensate underusage could be reason why underused Conclusion summary, early ABC management continues play important role treating when immediately available scenarios.