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Food Allergy Case Study for Pediatricians – Explanation to Question 5

Which is the most appropriate instruction regarding use of an epinephrine auto-injector?

Explanation to Question 5

Patients diagnosed with food allergy should carry a self-injectable epinephrine pen and have instructions regarding use. Recommended dosage is 0.15 mg of 1:1000 epinephrine for children weighing 15 to 30 kg (33 to 66 lbs) and 0.3 mg of 1:1000 epinephrine for anyone over 30 kg (66 lbs). Epinephrine should be given intra-muscularly in the thigh as evidence shows more rapid absorption and higher plasma epinephrine levels than with subcutaneous injections or intramuscular injections in the upper arm.

Epinephrine auto-injectors should also be available at home, daycare, and school. Demonstration of the epinephrine autoinjector and written instructions should be provided to the family. An naphylaxis emergency action plan should be provided to the family, daycare, and school.

Children should be instructed not to share or trade food with others and to notify adults if they eat something that may contain the food to which they are allergic.

The correct answer is C, epinephrine auto-injectors should be available at all times.


1. Sicherer SH, Estelle F, Simons R, Section on Allergy and Immunology. Self-injectable epinephrine for first aid management of anaphylaxis. Pediatrics 2007; 119:638-46.


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