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Published on: November 9, 2016
Pediatric anaphylaxis management in the prehospital setting
Gunjan Kamdar Tiyyagura1, Linda Arnold, David C Cone
1From the Department of Pediatric Emergency Medicine (GKT), the Department of Pediatrics (Emergency Medicine) (LA, ML), and the Department of Emergency Medicine (DCC), Yale University School of Medicine , New Haven , Connecticut .
Prehospital Emergency Care
|September 14, 2013
Summary
Epinephrine administration for anaphylaxis (a severe allergic reaction) is low among pediatric patients in prehospital settings. Increased education is crucial for timely treatment and improved outcomes.
Area of Science:
- Pediatric Emergency Medicine
- Allergy and Immunology
- Public Health
Background:
- Anaphylaxis is a severe, life-threatening allergic reaction requiring prompt treatment.
- Intramuscular epinephrine is the standard of care for managing anaphylaxis symptoms and reducing fatalities.
- Effective prehospital management is critical for pediatric patients experiencing anaphylaxis.
Purpose of the Study:
- To investigate the prehospital management of anaphylaxis in children.
- To assess the rates of epinephrine administration prior to arrival at a pediatric emergency department (PED).
- To identify factors influencing prehospital anaphylaxis treatment.
Main Methods:
- Retrospective chart review of pediatric patients (≤18 years) treated for anaphylaxis in a tertiary care PED.
- Data collection included demographics, symptoms, medical history, medications administered (route, provider), and disposition.
- Analysis focused on epinephrine administration by emergency medical services (EMS), school nurses, and parents/guardians.
Main Results:
- 218 cases of anaphylaxis in 202 children were reviewed; 98% had skin/mucosal symptoms, 68% respiratory.
- Food products were the most common allergen (76%); 67% had a history of allergic reactions.
- Epinephrine was administered prehospital in only 41% of cases, with lower rates by EMS and parents compared to school nurses or physicians.
Conclusions:
- Prehospital epinephrine administration for pediatric anaphylaxis is suboptimal.
- Low rates of administration by EMS providers and caregivers highlight a need for improved protocols and awareness.
- Enhanced education on anaphylaxis recognition and timely epinephrine use is imperative for better patient outcomes.
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