Effects of a structured educational intervention on knowledge and emergency management in patients at risk for anaphylaxis (original) (raw)
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SAFE: a multidisciplinary approach to anaphylaxis education in the emergency department
Annals of Allergy, Asthma & Immunology, 2007
Background: Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Allergists and emergency department (ED) physicians recognize the need for multidisciplinary efforts to increase public awareness of anaphylaxis, improve patient education, and enhance emergency and long-term management for the millions of Americans at risk for anaphylactic reactions.
Scholar: Pilot and Validation Studies, 2021
Anaphylaxis is a life-threatening allergic reaction that is often inadequately treated in the hospital setting, leading to adverse outcomes. We hypothesize that a brief educational intervention will enhance knowledge of community-based medical professionals evaluated by pre- and post-questionnaires, leading to improved recognition and management of anaphylaxis. An initial questionnaire consisting of eight multiple-choice questions and two fill in response pertaining to anaphylaxis identification, management, and treatment was completed by 189 University Hospitals Regional Hospitals personnel, including faculty, nurses, student, residents, and Emergency Medical Services (EMS). The participants were then offered an educational intervention, including a 10-slide, 20-minute PowerPoint presentation on anaphylaxis, and review of the pre-educational intervention questionnaire responses, followed by a post-educational intervention questionnaire similar to the initial questionnaire. Seventy-...
Journal of investigational allergology & clinical immunology, 2018
After a diagnosis of anaphylaxis, patients receive action management plans to prevent and treat new episodes, including attending the Emergency Departments (ED) for control or further treatment. In a previous study, we observed that more than half of the children with anaphylaxis were incorrectly prioritized in our Paediatrics Emergency Unit (PEU), delaying their treatment. In conjunction with our PEU staff we designed a basic educational intervention (BEI) to try to solve this problem. We analyzed the effect of this intervention in the effective triage of the subsequent children diagnosed with anaphylaxis. Our BEI consisted of a formative lecture given to the PEU triage nurses and the design of a Reference Card highlighting anaphylaxis symptoms and risk factors. We included 138 children with medical diagnosis of anaphylaxis and assessed modifications in their triage priority level and waiting times for physician (WT) after our intervention. According to the EI implementation date, ...
A Simple Allergist-Led Intervention Improves Resident Training in Anaphylaxis
Journal of Allergy, 2016
Physicians underrecognize and undertreat anaphylaxis. Effective interventions are needed to improve physician knowledge and competency regarding evidence-based anaphylaxis diagnosis and management (ADAM). We designed and evaluated an educational program to improve ADAM in pediatrics, internal medicine, and emergency medicine residents from two academic medical centers. Anonymous questionnaires queried participants’ demographics, prior ADAM clinical experience, competency, and comfort. A pretest assessing baseline knowledge preceded a 45-minute allergist-led evidence-based presentation, including practice with epinephrine autoinjectors, immediately followed by a posttest. A follow-up test assessed long-term knowledge retention twelve weeks later. 159 residents participated in the pretest, 152 participated in the posttest, and 86 participated in the follow-up test. There were no significant differences by specialty or site. With a possible score of 10, the mean pretest score (7.31 ± 1...
Preparedness and Knowledge Level of Family Physicians Regarding Anaphylaxis Diagnosis and Management
Balıkesir sağlık bilimleri dergisi, 2023
Objective: Anaphylaxis is under-recognized and undertreated by physicians, indicating critical knowledge gaps. This study aimed to assess the knowledge levels of anaphylaxis among family physicians (FPs) as they are the primary first-line healthcare providers and identify the factors influencing their knowledge levels. Materials and Methods: A cross-sectional study using an internet-based Google Forms questionnaire was conducted among voluntary FPs in Sivas, Turkey. Demographic features, including age, years in practice, and career position, and knowledge related to the diagnosis and management of anaphylaxis in children were assessed. Results: A total of 140 FPs participated in the survey (34 [24.3%] general practitioners [GPs], 20 [14.3%] contracted family physicians [CFPs], 74 [52.9%] residents in training [RITs], and 12 [8.6%] specialists). The number of participants who correctly answered all questions regarding diagnosis, acute treatment, and epinephrine auto-injector use was 11 (7.9%), 52 (37.4%), and 27 (19.3%), respectively. In diagnosing anaphylaxis, 100 (72.5%) participants were unaware that anaphylaxis can occur without skin manifestations, and only 48 (34.8%) identified gastrointestinal symptoms as a possible anaphylaxis presentation. RITs (11, 14.9%) and specialists (2, 16.7%) had better performance on the questionnaire, with higher proportions of participants who answered all questions correctly, compared to GPs (2, 5.9%) and CFPs (1, 5.0%). Attendance at an educational activity in the last year was the only independent factor associated with answering all questionnaire items correctly. Conclusion: There is a need to improve anaphylaxis recognition and management among all FPs regardless of their career position and work experience, underlining the importance of regular and updated educational interventions.
Journal of child science, 2020
Anaphylaxis is a severe, life threatening generalized or systemic hypersensitivity reaction which requires prompt, accurate diagnosis, and appropriate management. The objective of the study is to assess the extent of knowledge, management skills, and attitude on anaphylaxis among pediatric health care providers of a tertiary care teaching hospital. This was a cross-sectional study done in the department of pediatrics, which included faculty, residents, interns, and nurses. The knowledge, attitude, and practice were assessed using a standardized questionnaire comprised of 35 questions. The questionnaire was distributed and collected in person to all the participants. Informed consent was obtained from all participants and confidentiality was ensured at all stages. Collected data were analyzed using SPSS version 20. The mean of total knowledge score (TKS) was 7.36 AE 1.42. TKS of faculty was 8.36 AE 1.15, in residents 7.81 AE 1.25, in interns 7.46 AE 1.15, and in nurses 6.69 AE 1.57. Knowledge scores of faculty, residents, and interns were significantly higher than that of nurses while there was no significant difference between faculty, residents, and interns. The majority of participants have positive attitude toward anaphylaxis. Incorrect practice is followed by most of the participants. The extent of knowledge about anaphylaxis among pediatric health care providers is moderate but management skills remains suboptimal. Thus, proper training, through continued medical educations and programs to improve abilities to recognize and manage anaphylaxis are very crucial. Differential approach may be followed to different groups; nurses need extra training for optimal management of anaphylaxis.
Knowledge of anaphylaxis among Emergency Department staff
Asia Pacific Allergy, 2014
Anaphylaxis is an emergency condition that requires immediate, accurate diagnosis and appropriate management. However, little is known about the level of knowledge of doctors and nurses treating these patients in the Emergency Department. Objective: To determine the knowledge of doctors and nurses in the Emergency Department on the recent definition and treatment recommendations of anaphylaxis. Methods: We surveyed doctors and nurses of all grades in a tertiary Hospital Emergency Department using a standardized anonymous questionnaire. Results: We had a total of 190 respondents-47 doctors and 143 nurses. The response rate was 79.7% for doctors and 75.3% for nurses. Ninety-seven point eight percent of the doctors and 83.7% of the nurses chose the accepted definition of anaphylaxis. High proportions of doctors (89-94%) and nurses (65-72%) diagnose anaphylaxis in the three scenarios demonstrating anaphylaxis and anaphylactic shock. Forty-two point six percent of the doctors and 76.9% of the nurses incorrectly diagnosed single organ involvement without hypotension as anaphylaxis. As for treatment, 89.4% of the doctors indicated adrenaline as the drug of choice and 85.1% chose intramuscular route for adrenaline administration. Among the nurses, 40.3% indicated adrenaline as the drug of choice and 47.4% chose the intramuscular route for adrenaline. Conclusion: High proportion of doctors and nurses are able to recognize the signs and symptoms of anaphylaxis, although there is a trend towards over diagnosis. There is good knowledge on drug of choice and the accepted route of adrenaline among the doctors. However, knowledge of treatment of anaphylaxis among nurses was moderate and can be improved.
Adults and children with anaphylaxis in the emergency room: why it is not recognized?
Current Opinion in Allergy & Clinical Immunology, 2018
Purpose of review Despite many international guidelines have been published in the last 10 years, anaphylaxis continues to be underdiagnosed, undernotified, and undertreated. Anaphylactic reactions in adults and children in emergency departments are frequently not recognized, leading to underutilization of epinephrine, and a higher risk of death. Recent findings A few studies have been recently published showing that educational intervention for both physicians and other healthcare professionals improve diagnosis and treatment of anaphylaxis. Moreover, the new International Classification of Diseases, 11th edition improved classification of anaphylaxis, making it easier to be notified. Summary Anaphylaxis is a life-threatening hypersensitivity reaction that is most frequently seen by emergency physicians and nurses than allergists or immunologists. Education seems to be best strategy to improve management of this severe condition.
How to manage anaphylaxis in primary care
Clinical and Translational Allergy
Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction characterized by rapidly developing airway and/or circulation problems. It presents with very different combinations of symptoms and apparently mild signs and can progress to fatal anaphylactic shock unpredictably. The difficulty in recognizing anaphylaxis is due, in part, to the variability of diagnostic criteria, which in turn leads to a delay in administration of appropriate treatment, thus increasing the risk of death. The use of validated clinical criteria can facilitate the diagnosis of anaphylaxis. Intramuscular epinephrine (adrenaline) is the medication of choice for the emergency treatment of anaphylaxis. Administration of corticosteroids and H1-antihistamines should not delay the administration of epinephrine, and the management of a patient with anaphylaxis should not end with the acute episode. Long-term management of anaphylaxis should include avoidance of triggers, following confirmation by an allergology study. Etiologic factors suspected in the emergency department often differ from the real causes of anaphylaxis. Evaluation of patients with a history of anaphylaxis should also include an assessment of personal data, such as age and comorbidities, which may increase the risk of severe reactions. Special attention should also be paid to co-factors, as these may easily confound the cause of the anaphylaxis. Patients experiencing anaphylaxis should administer epinephrine as soon as possible. Education (including the use of Internet and social media), written personalized emergency action plans, and selfinjectable epinephrine have proven useful for the treatment of further anaphylaxis episodes.