{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:41:49Z","timestamp":1787730109533,"version":"build-2784847793"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Anaphylaxis is a potentially life-threatening reaction requiring prompt treatment with intramuscular epinephrine (EPI). We sought to describe presenting features of pediatric anaphylaxis and compare patient characteristics and outcomes of children treated with prehospital EPI with those untreated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We abstracted data from emergency department (ED) records for children meeting the National Institute of Allergy &amp; Infectious Disease criteria for anaphylaxis (2015\u20132017) in one tertiary care children's hospital. We analyzed associations between patient characteristics and outcomes and receipt of prehospital EPI using descriptive statistics and multivariate logistic regression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 414 children presenting with anaphylaxis, 39.4% received IM EPI and 62.1% received antihistamines before hospital arrival. Children with Medicaid received pre\u2013emergency department EPI less frequently than did children with private insurance (24.5% vs 43.8%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001). Factors positively associated with prehospital EPI administration were history of food allergy (odds ratio [OR], 4.4 [95% confidence interval {CI}, 2.4\u20138.2]) or arrival by emergency medical services (OR, 8.0 [95% CI, 4.2\u201315.0]). Medicaid insurance was associated with decreased odds of prehospital EPI (OR, 0.33 [95% CI, 0.16\u20130.66]) and prehospital H1-antihistamine use (OR, 0.30 [95% CI, 0.17\u20130.56]). Prehospital EPI treatment was also associated with decreased rates of observation (37% vs 63%), inpatient admission (38% vs 62%), and intensive care unit admission (20% vs 80%) compared with no pretreatment (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Prehospital treatment with EPI remains low, and barriers to optimal treatment are more pronounced in children with public insurance. Prehospital treatment with EPI was associated with decreased morbidity including hospitalization and intensive care unit admission.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002146","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T13:56:59Z","timestamp":1592315819000},"page":"e69-e74","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Outcomes and Factors Associated With Prehospital Treatment of Pediatric Anaphylaxis"],"prefix":"10.1097","volume":"38","author":[{"given":"Jennifer L.","family":"Trainor","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary E.","family":"Pittsenbarger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruchi S.","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/S1081-1206(10)60315-8","article-title":"Increasing anaphylaxis hospitalizations in the first 2 decades of life: New York State, 1990\u20132006","volume":"101","year":"2008","journal-title":"Ann Allergy Asthma Immunol"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1111\/acem.12922","article-title":"Variation and trends in anaphylaxis care in United States children's hospitals","volume":"23","year":"2016","journal-title":"Acad Emerg 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