Physicians' Approach to Anaphylaxis in Childhood

Abstract

Objectives: Anaphylaxis is a life-threatening, severe, generalized, or systemic hypersensitivity reaction. The incidence of anaphylaxis is increasing especially in pediatric age. Our aim in this study was to investigate the knowledge and attitudes of the physicians on the diagnosis and treatment of anaphylaxis.Methods: A questionnaire form consisting of a total of 18 questions was prepared. Six questions concerned demographic data; 7 questions inquired about physician's knowledge level about treatment of anaphylaxis. In the last part, 5 different case scenarios were given, and their diagnoses and treatments were asked.Results: A total of 120 physicians participated in the study. Of the participants, 66.7% were residents. The rate of correct answer about dose of epinephrine was 57.5%. The rates of making correct diagnoses in anaphylaxis case scenarios 1, 2, and 3 were 60%, 73.3%, and 91.7%, respectively, whereas epinephrine administration rates were 54%, 67.5%, and 92.5%, respectively. When the answers of all these questions given by the residents and specialists and among physicians who updated and did not update were compared, there were no statistically significant differences except epinephrine administration rate and its route (P < 0.05). Conclusions:The results of the current study suggest that physicians' knowledge levels were inadequate in making the diagnosis of anaphylaxis, and physicians use epinephrine in conditions without hypotension or an undefined possible/known allergen contact. Information about epinephrine administration was partially correct. It is currently considered to be the simplest measure to have a written anaphylaxis action plan including diagnostic criteria for anaphylaxis.

Level of knowledge among healthcare professionals regarding anaphylaxis

“…In this context, it can be concluded that the older participants with longer work experience have not updated their knowledge of the epinephrine administration route in accordance with the current literature. Similar observations were made in recent studies in our country conducted by Tuncel et al [ 17 ] and in Tehran by Fakheri and Movahedi et al [ 35 ].…”

“…Our study, including healthcare professionals from different healthcare institutions, showed that there was a lack of knowledge among healthcare professionals regarding the acute treatment of anaphylaxis such as the dose of epinephrine, and long-term therapy such as EAI doses, and prescribing rates. This lack of knowledge was similar to previous studies conducted in Turkey and different countries [ 16 17 18 19 20 ].…”

Winning the war against anaphylaxis requires continued professional patient manegement till discharge

“…10 Recently in a 2020 study, a total of 120 physicians participated, the rate of correct answer about promptly choosing epinephrine as first drug of choice in treatment was 87.5%. 1 Similarly, in our study 88.7% of the participating physicians gave the correct answer about giving adrenalin as 1st choice in anaphylaxis as soon as possible. But about the route of administration, the ratio dropped to 66.7%.…”

“…Anaphylaxis is a life-threatening systemic reaction affecting all age groups. 1 High rates of hospitalization for anaphylaxis have been reported in different countries of the world. 2 The cases of anaphylaxis might have to be managed by doctors from different specialities.…”

Healthcare workers` knowledge level regarding anaphylaxis and usage of epinephrine auto-injectors

“…[22][23][24] Nevertheless, the rate of pediatricians in our country choosing the epinephrine dose correctly has not changed significantly in the last seven years, in fact it has even decreased. 13,25 However, it is absolutely necessary to apply all steps in the management of a case of anaphylaxis immediately and correctly for preventing irrecoverable outcomes for the patient. 1,2 In this regard, in another study in which we assessed pediatricians' competence in anaphylaxis management through case scenarios, we ascertained that only 11.3% of the physicians were able to correctly apply all management steps from diagnosis to discharge recommendations.…”