In the case of life-threatening food anaphylaxis in childhood and adolescence, there are often critical delays in the administration of life-saving epinephrine auto-injectors (EpiPen). This is the result of a study by the University of Bristol and Bristol Children’s Hospital, which was presented at the annual meeting of the Royal College of Emergency Medicine on 28 April.

The researchers evaluated data from the National Childhood Mortality Database on 19 children who had died of a severe food allergy between 2019 and 2023. In 74 percent of cases, no or only a single epinephrine auto-injector was administered before cardiac arrest. 37 percent of the children did not have an auto-injector with them at all.

The average time from symptom onset to cardiac arrest was only 14 minutes. All 19 children suffered the cardiac arrest before reaching an emergency room. Young people between the ages of 15 and 17 (47 percent) and children between the ages of 10 and 14 (42 percent) were particularly affected.

A second analysis of 17 cases showed that in almost all cases, lung failure (respiratory and respiratory problems) was the actual cause of death. However, the current NHS guidelines focus primarily on cardiovascular problems. The authors therefore call for an adjustment of the guidelines in order to give greater priority to airway protection and early, possibly multiple doses of adrenaline.

The studies underline that severe food anaphylaxis is rare, but largely preventable. The researchers advocate improved education, consistent carrying of auto-injectors and updated emergency protocols in hospitals.

Original Paper:

Airway, breathing or circulation failure in fatal food anaphylaxis: a nationally representative case series’ by John Coveney, Tom Roberts, Sylvia Stoianova, Nicholas Sargant, in Clinical & Experimental Allergy
doi: 10.1111/cea.70175

Editor: X-Press Journalistenbüro GbR

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