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The optimal duration of monitoring to capture rebound anaphylaxis after epinephrine administration for pediatric anaphylaxis is unknown; 4 hours is standard in many pediatric emergency departments (EDs). To further refine the optimal duration, investigators analyzed 5600 encounters for pediatric anaphylaxis across 30 U.S. and Canadian hospitals. The mean age of patients was 8 years, and food was the most common trigger (88%), with peanuts most commonly implicated.
Four percent of patients required 2 doses of epinephrine in the ED, and 0.4% received 3 or more doses. The incidence of biphasic anaphylaxis (recurrent anaphylaxis after a symptom-free period of ≥1 hour) was 1.5%.
The time from first to last dose of epinephrine was…