The Short of It
Not all doctors are telling parents of kids with food allergies how to properly use EpiPens.
If your child has a food allergy, knowing how to use an EpiPen in an emergency situation can be the difference between life and death. Yet according to a new study, less than 70 percent of parents say their allergist explained when to use epinephrine, and less than 40 percent said the same of their pediatricians. Even fewer recalled being shown how to use epinephrine or being given a written emergency action plan.
"There is a gap in the communication between doctors and parents in management of their children's food allergies that we need to fix," said Dr. Ruchi Gupta, an associate professor in pediatrics at Northwestern University Feinberg School of Medicine and a physician at Lurie Children's Hospital. "These points need to be hammered home by the physician at every visit. This is potentially lifesaving information."
Part of the problem is that not all physicians prescribe epinephrine for all food allergy diagnoses, even though it's part of the treatment guidelines. And even though childhood food allergies affect 8 percent of children in the United States, many pediatricians aren't even adequately trained on how to use EpiPens and don't feel comfortable showing patients how to use the devices, Gupta said.
According to the study's authors, doctors need to be trained in the best practice guidelines and how to communicate the guidelines to patients. They should make sure patients understand when and how to use epinephrine, and they should write up an emergency action plan that describes—for all potential caregivers—common symptoms of a food allergy reaction and what to do if a child has mild versus severe symptoms.
And even then, "Physicians have to make sure the parents can repeat back the directions," Gupta said. "Parents may not be digesting all the information given to them in a short period of time."
Among those surveyed, peanut allergy was the most common, followed by milk, eggs, and tree nuts. About half of children with a food allergy had experienced a severe allergic reaction. Yet while the majority of parents reported quality health care from their children's pediatricians and allergists, they said they lacked the essential guidance necessary to manage their child's food allergy.
My kids don't have any known allergies, but a lot of their friends do. I recently watched one mom use an EpiPen when her son went into anaphylactic shock at a supposedly nut-free party. I don't even want to think about what would have happened if she hadn't been given the pen or hadn't known how to use it. Physicians really need to step up their game.