A recent study assessing emergency room records confirms the fact that a significant number of patients with anaphylactic reactions to food needed more than one injection of epinephrine. The data from this study revealed that 16% of patients presenting with food induced anaphylaxis required two injections. Previous data showed that as many as 25% of reactions required multiple doses. Multiple doses of epinephrine appeared to be more likely in those with reactions to peanuts and tree nuts and those presenting with hypotension.

The message is clear: Those with a history of anaphylaxis and those highly allergic to foods, medicines, or insect stings should be prepared to treat anaphylaxis with multiple injections of epinephrine until medical assistance arrives. One may not be enough!