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Management of anaphylaxis in child care centers: evaluation 6 and 12 months after an intervention program
Bina M Patel1, Priya J Bansal, Mary C Tobin
1Department of Allergy and Immunology, Rush University Medical Center, Chicago, Illinois 60612-3824, USA. b-patel@me.northwestern.edu
Insights
Child care providers initially improved anaphylaxis management after an allergy seminar, but knowledge faded over time. Regular retraining is crucial for recognizing anaphylaxis symptoms and administering epinephrine correctly.
Area of Science:
- Pediatric Allergy and Immunology
- Child Care Health and Safety
- Emergency Medical Response
Background:
- Young children with allergies frequently attend child care, necessitating trained staff.
- Previous studies identified significant knowledge gaps in anaphylaxis recognition and management among child care providers.
- Enhanced anaphylaxis education is vital for child care settings.
Purpose of the Study:
- To assess the sustained ability of child care centers to recognize, evaluate, and treat anaphylaxis in young children one year after an allergy seminar.
- To determine the long-term impact of anaphylaxis education on child care provider knowledge and skills.
Main Methods:
- Follow-up surveys were administered to 39 child care centers 6 months and 1 year post-allergy seminar.
- Questionnaires assessed recognition, evaluation, and treatment of anaphylactic episodes.
- Centers that did not attend the seminar or complete prior surveys were excluded.
Main Results:
- A significant improvement in knowing when to administer epinephrine was observed initially, but correct administration knowledge declined from 77% (post-seminar) to 48% (6 months) and 31% (1 year).
- Recognition of typical anaphylaxis symptoms like abdominal cramping and shortness of breath decreased over time.
- Identification of symptoms such as hives, swelling, and wheezing remained consistent.
Conclusions:
- Anaphylaxis education for child care providers yields initial improvements but requires reinforcement due to knowledge attrition.
- Periodic retraining is essential to maintain and enhance anaphylaxis recognition, evaluation, and treatment skills.
- Sustained vigilance and ongoing education are critical for ensuring child safety in child care settings.
Background:
Many young children with a history of allergic reactions or anaphylaxis spend considerable time in child care centers. We previously reported that a significant knowledge deficit exists in anaphylaxis recognition, evaluation, and treatment and that greater anaphylaxis education is needed among child care providers.
Objective:
To determine whether child care centers can recognize, evaluate, and treat anaphylactic episodes in children aged 1 to 6 years 6 months and 1 year after attending an allergy seminar.
Methods:
All 39 child care centers participating in the original study were selected to complete 6-month and 1-year follow-up surveys using a similar questionnaire. Those who did not attend the seminar or complete all the previous surveys were excluded.
Results:
At 6 months and 1 year, 37 and 29 centers, respectively, completed surveys. There was a significant improvement regarding when to administer intramuscular epinephrine compared with before the allergy seminar. However, only 48% of the centers at 6 months (P = .02) and 31% at 1 year (P = .002) knew how to correctly administer intramuscular epinephrine compared with 77% four weeks after the seminar. With time, there was a significant decline in correctly recognizing typical anaphylaxis symptoms, including abdominal cramping, chest tightness, shortness of breath, low blood pressure, and diarrhea, whereas symptoms such as hives, swelling, and wheezing continued to be identified correctly.
Conclusions:
There is a need for renewed anaphylaxis education among child care providers. Initially, this intervention significantly increased the ability of child care center staff to recognize, evaluate, and treat anaphylaxis, but knowledge diminished gradually at 6-month and 1-year follow-up.
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