I alway worry about this biphasic response and is suppose to be up to 20%
in food allergens anaphylaxis. They discuss the biphasic response can be 10
times greater then the initial response wow that would be one sick patient.
The other thing I wonder how many give activated charcoal for food allergy
especially peanut allergy? I have seen a couple articles which I can
forward if any one wants them. Not large randomized control trial of
The last comment which I have seen is a patient getting intubated because
or peanut anaphylaxis and was placed on a propofol drip for sedation. The
propofol has a soy based protein moiety that can cross react with peanut
allergy and initially when propofol was approved in 2000 in the US it was
not a contraindication and now is since 2003 which is not commonly taught.
I think it is nice to have rough estimates of how long to watch patient but
every scenario and patient is not alike.
Joshua Bigler, MD
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