Ari R. Cohen, MD, FAAP: Epinephrine Recommended for Pediatric Anaphylaxis

Though anaphylaxis has been thoroughly discussed in the field of allergy and pediatric research, the recommendations for treatment may vary, especially when considering pediatric populations.

In an interview with HCPLive, Ari R. Cohen, MD, FAAP, Chief of Pediatric Emergency Medicine, Massachusetts General Hospital, spoke of the efficacy and safety of emergency epinephrine injections, which he believed to be the first choice in treating pediatric patients in most cases.

Cohen spoke on this subject in his presentation, “Anaphylaxis Update: Be Prepared!”, a session which occurred at the American Academy of Pediatrics (AAP) 2021 Virtual Conference this weekend.

Several parent-reported studies were incorporated into Cohen’s session, many of which detailed the myriad of different symptoms younger patients experience with anaphylaxis.

Though some symptoms such as rashes and respiratory distress are noticeable by caregivers and clinicians, others such as motility of the intestines or vomiting might not immediately be considered symptoms relating to anaphylaxis.

Regardless, Cohen noted that several treatment methods such as the use of steroids have been commonly accepted in caregiver and clinical groups. However, he added that steroids, unlike epinephrine, do not provide immediate medical relief in the case anaphylaxis.

Epinephrine, he said, provides not only immediate relief for pediatric patients experiencing anaphylaxis, but is also a cost-effective and widely available treatment method.

In emergency rooms, for instance, epinephrine can be administered by nurses via standard vials and injections.

Cohen hoped that the future of anaphylaxis treatment in pediatric populations would entail the de-stigmatization of epinephrine in both caregiver and clinical communities, citing “little downside” to its use.

“So I think that my general principle is that think about epinephrine as the treatment for anaphylaxis; if you do nothing else from this session, that's the thing you should take home,” Cphen said, “Most people in pediatrics and that take care of kids understand that, but you should not delay giving epinephrine to give anything else.”

To hear more from Dr. Cohen on his AAP session on anaphylaxis, watch the video above.