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Entries in EpiPen (3)

Wednesday
Feb152012

EpiPen to Stop Epileptic Seizures?

Getty Images/Photo Researchers RM(ANN ARBOR, Mich.) -- The longer an epileptic seizure lasts, the more likely it is to turn deadly.

Besides administering an oral or anal gel suppository -- which can be difficult to give successfully in the midst of a seizure -- caregivers are at a race against time, with little to do but wait for paramedics to arrive.

But researchers at the University of Michigan and the University of Cincinnati say creating an insertible pen to stop seizures -- much like the popular EpiPen used widely for treating acute allergic reactions -- may prove to be a lifesaver.

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In a new study, published Wednesday in the New England Journal of Medicine, researchers found that injecting emergency anti-seizure medication into the muscle can stop prolonged seizures -- seizures that last for five minutes or longer -- faster than if it were administered through an IV line administered by a paramedic.

Nearly 900 patients with epilepsy who experienced seizures lasting longer than five minutes either were given a shot in the muscle with the anticonvulsant midazolam by paramedics or the standard IV line of the anticonvulsant drug lorazepam.

On average, the seizures were shorter for those patients who were administered a shot of midazolam directly into the muscle, lasting just 1 1/2 minutes after the medication was injected. Patients who received anticonvulsant drugs by IV drip, by contrast, suffered longer seizures, which continued on average for as long as five minutes before the treatment took effect.

Nearly 55,000 people die each year from prolonged seizures, according to Dr. Robert Silbergleit, emergency physician at the University of Michigan Health System, and lead author of the study.

"It's difficult to start an IV in somebody who's having convulsions, who's shaking, and that difficulty can cause a delay in getting the IV started, which can cause a delay in stopping the seizure," said Silbergleit. "And it can also be a safety hazard for the paramedic who's got a sharp object and a shaking patient," he said.

Although paramedics administered the shot to patients in the study, the findings could pave the way for a shot that can be administered by caregivers before paramedics even arrive, according to Dr. Jason McMullan, assistant professor of clinical emergency medicine at the University of Cincinnati and co-author of the study.

"The earlier they are treated, the sooner the seizure will stop, the easier it will be to control and the better the outcome," said McMullan.

The study enrolled adults and children as young as 2 years old.

"Most seizures stop on their own without any type of medication," said McMullan, adding that the findings only apply to those who have prolonged seizures, known as status epilepticus.

Midazolam, one drug in a class of medications called benzodiazepines, can be used to stop seizures. Other benzodiazepines, diazapem and lorazepem are anticonvulsants currently used anally and in IV form, respectively.

"I am very excited that this is another tool in the arsenal for present lifesaving treatments for prolonged seizures," said McMullan.

Although midazolam currently is used off-label to stop seizures, syringes with a standard dose of the medication -- such as those used in the study -- are not currently approved by the U.S. Food and Drug Administration.

While it might take a while until an auto-injector "epi-pen" of the medication is approved for caregivers, McMullan said paramedics can use the technique now.

"They can draw it up in a syringe and use it as a shot, just like how medications are given," said McMullan.

Copyright 2012 ABC News Radio

Thursday
Jan122012

Allergic Girl Who Died at School Got Peanut from Another Child

Getty Images/Photo Researchers RM(RICHMOND, Va.) -- Ammaria Johnson, the 7-year-old Virginia girl who died after an allergic reaction at school, was given a peanut by another child unaware of her allergy, police said.

Johnson ate the peanut on the playground of her Chesterfield County elementary school, Hopkins Elementary, during recess. After noticing hives and shortness of breath, she approached a teacher and was taken to the school clinic. A clinic aid was trying to help her when she stopped breathing, according to police.

"When emergency crews arrived, she was already in cardiac arrest in the clinic," Lt. Jason Elmore, a spokesman for the Chesterfield County Fire Department, told ABC News.

An investigation by Chesterfield police concluded that Johnson died from cardiac arrest and anaphylaxis, and that no crime or criminal negligence was committed by the child who shared the peanut, school personnel or Johnson's mother.

"Although not a crime, Amarria's death is a tragedy and the Chesterfield County Police Department expresses its deepest sympathies to her family, classmates and school personnel as they deal with this difficult and painful event," police chief Col. Thierry Dupuis said in a statement.

Johnson's death raised questions about how schools and parents should handle severe allergies. Experts say Johnson could have been saved by an EpiPen -- a device that injects epinephrine to reverse the symptoms of anaphylaxis, currently available only by prescription. But Hopkins Elementary had no such device on hand for Johnson.

Chesterfield County school policy states that parents are responsible for providing the school "with all daily and emergency medications prescribed by the student's health-care provider," and keeping medications up to date.

But a proposed bill would encourage states to adopt laws requiring schools stock EpiPens like bandages and other first-aid supplies for any student or staff member in an anaphylactic emergency. The bill would include liability protection for school officials who give epinephrine in good faith.

Copyright 2012 ABC News Radio

Thursday
Jan052012

Allergic Girl's Death Raises Questions About School's Responsibility

Getty Images/Photo Researchers RM(RICHMOND, Va.) -- The death of a Virginia first grader has raised questions about how schools should handle severe allergies.

Ammaria Johnson, 7, died Monday after suffering an allergic reaction during recess at her Chesterfield County elementary school, Hopkins Elementary.

"She came to the school clinic after feeling she had hives and shortness of breath," Lt. Jason Elmore, a spokesman for the Chesterfield County Fire Department, told ABC News. It's unclear how long Johnson was in the clinic before school officials called 911 at 2:26 p.m.

"When emergency crews arrived, she was already in cardiac arrest in the clinic," said Elmore.

Johnson was rushed to a local hospital where she was pronounced dead.

What caused the reaction is still under investigation, but Johnson's mother, Laura Pendleton, told local reporters the girl had a peanut allergy.

"We can only assume that at this time," said Elmore. "We have EMS protocols in place for allergic reactions and we performed those in hopes of saving her life, but unfortunately this time we could not."

Calls to Pendleton were not immediately returned. She arrived at the hospital after Johnson had died, Elmore said.

The death is still under investigation by the Chesterfield County Police Department, according to a spokeswoman, but the state medical examiner will not be involved.

Experts say Johnson could have been saved by an EpiPen -- a device that injects epinephrine, currently available only by prescription.

"The epinephrine reverses severe symptoms, giving time to get the person to an emergency room for monitoring and more care," said Dr. Scott Sicherer of the Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York.

But Hopkins Elementary had no such device on hand for Johnson.

Chesterfield County school policy states that parents are responsible for providing the school "with all daily and emergency medications prescribed by the student's health-care provider," and keeping medications up to date.

"For any medication, the school would have to be in possession of that medication to provide it," said Shawn Smith, a spokesman for Chesterfield County Public Schools. Even if the school had an EpiPen prescribed for another student, they would not be able to use it.

"The medication we receive, or should receive, has to be specific to that child, whether it's over-the-counter or prescription," Smith said.

Smith declined to comment on Johnson's case specifically, but said managing severe allergies starts at home.

"At the beginning of the school year, we sent information to parents outlining the different responsibilities for the family and the child, the principal, the teacher, the doctor and the nurse," he said. "First and foremost, is does begin at home. Working with their doctor, the family would outline a health care plan that deals with those severe allergies."

Pendleton told local reporters her daughter did have a plan, but said the school refused to take Johnson's EpiPen and failed to give her Benadryl -- an over-the-counter antihistamine also listed in her plan -- at the first sign of a reaction.

Because severe allergies can develop without warning, some experts say schools should stock EpiPens like bandages and other first-aid supplies.

A school EpiPen stash could soon be a reality with a proposed bill that would encourage states to adopt laws requiring schools to have EpiPens on hand. The School Access to Emergency Epinephrine Act, proposed in December 2011, would mean EpiPens could be used for any student or staff member in an anaphylactic emergency.

The bill would include liability protection for school officials who give epinephrine in good faith, according to Maria Acebal, chief executive officer of the Fairfax, Va.-based Food Allergy and Anaphylaxis Network, which championed the bill.

"No one in this country has ever been sued for giving epinephrine, to my knowledge," said Acebal. "All the lawsuits come about because school officials don't give it when it's needed."

In a healthy child, epinephrine can cause a rapid heart rate, nausea and light-headedness -- mild symptoms that wear off in 15 minutes. It would only be dangerous in children born with a congenital heart condition, which school officials would be aware of.

Acebal, whose eldest daughter has a food allergy, said her other children learned how to inject epinephrine by age 6.

"If I can teach a 6-year-old to do it, we can teach school staff," she said.

Acebal said having epinephrine on hand in school would give students, staff and parents added peace of mind.

"My heart breaks for Ammaria's family because any parent who has a child with a food allergy knows what it's like to fear that phone call from the school," she said.

Copyright 2012 ABC News Radio







ABC News Radio