Most individuals with life-threatening allergies who are at risk of anaphylaxis are advised to carry two doses of epinephrine injections (such as Twinject or EpiPen 2-Pak), administered in cases of severe allergic reaction.

Although some people may not need the second dose, in some cases, the second dose may spell the difference between life and death.

A recent study indicates that nearly 1-of-5 cases of food-induced anaphylaxis in children required a second dose of epinephrine, and nearly all of those who required multiple doses of epinephrine also suffered from asthma.

Järvinen and colleagues from Mount Sinai School of Medicine studied the histories of 413 food-allergic children. They identified 78 patients who had received epinephrine to treat a total of 95 anaphylactic reactions. Parents of the children were asked to recall the suspected food trigger, how rapidly symptoms developed and the timing of treatment.
Of the 95 reactions treated with epinephrine, a second dose of the medication was administered in 19 percent of cases (18 patients). A third dose was required in 6 percent of cases (6 cases).

Of those who received multiple doses, all but one (94 percent) were also diagnosed with asthma.

Thus, the authors of the study suggests that "the recommendation to carry two doses of epinephrine should as minimum be extended to individuals with asthma and significant food allergies."

My son belongs to that category, and obviously this report ups my anxiety levels.