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Improving anaphylaxis management in a pediatric emergency department
E Arroabarren1, E M Lasa, I Olaciregui
1Emergency Unit, Pediatrics Department, Hospital Universitario Donostia, San Sebastián, Spain. esoziaa@yahoo.es
Summary
An updated anaphylaxis protocol significantly improved pediatric emergency care, increasing epinephrine use and self-injecting epinephrine prescriptions. The protocol enhanced physician management skills with no significant adverse effects observed from epinephrine administration.
Area of Science:
- Pediatric Emergency Medicine
- Allergy and Immunology
- Clinical Protocol Development
Background:
- Management of anaphylaxis in pediatric emergency units (PEU) often shows deficiencies in diagnosis, treatment, and follow-up.
- There is a need to assess the effectiveness of updated protocols to improve medical performance in managing pediatric anaphylaxis.
- Understanding the incidence of anaphylaxis and the safety of epinephrine use in a PEU is crucial.
Purpose of the Study:
- To evaluate the efficiency of an updated anaphylaxis management protocol in a pediatric emergency unit.
- To determine the incidence of anaphylaxis in children under 14 years old.
- To assess the safety of epinephrine administration in the pediatric emergency setting.
Main Methods:
- A before-and-after comparative study was conducted using clinical histories of children diagnosed with anaphylaxis.
- Data were collected from 2006-2007 (pre-protocol) and 2008-2009 (post-protocol).
- Key metrics included anaphylaxis incidence, epinephrine use, self-injecting epinephrine prescription, admissions, length of stay, and adverse events.
Main Results:
- Anaphylaxis incidence was 4.8 per 10,000 cases/year.
- Post-protocol implementation, epinephrine administration increased from 27% to 57.6%, and self-injecting epinephrine prescriptions rose from 6.7% to 54.5%.
- Significant improvements were noted in hospital admissions, reduced corticosteroid monotherapy, and better patient discharge instructions, with epinephrine use showing no significant adverse effects.
Conclusions:
- The implemented anaphylaxis protocol significantly enhanced physician management skills in the pediatric emergency unit.
- Epinephrine administration, a critical treatment for anaphylaxis, was found to be safe in this pediatric population.
- The study highlights the positive impact of protocol updates on pediatric anaphylaxis care.
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