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Detection and management of Anaphylaxis in children

Ana Laura Fustiñana1, Pedro B Rino1, Guillermo A Kohn-Loncarica1

  • 1Unidad de Emergencias, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Argentina.

Revista Chilena De Pediatria
|May 17, 2019
PubMed

Insights

Pediatricians struggle with anaphylaxis recognition and treatment. While most select epinephrine, many misadminister it, highlighting a critical knowledge gap in emergency care.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Toxicology
  • Medical Education

Background:

  • Anaphylaxis is a life-threatening emergency requiring prompt recognition and treatment.
  • Intramuscular epinephrine is the recommended first-line treatment for anaphylaxis, improving survival rates.

Purpose of the Study:

  • To assess pediatricians' knowledge of anaphylaxis diagnosis and management.
  • To identify gaps in understanding critical treatment protocols.

Main Methods:

  • A cross-sectional descriptive study utilizing an anonymous, validated survey.
  • Survey administered to pediatric residents at a tertiary care hospital.
  • Statistical analysis included descriptive statistics and Chi-square tests (p < 0.05 significance).

Main Results:

  • 35% of pediatricians correctly identified all anaphylaxis clinical criteria.
  • 99% selected epinephrine, but only 48% chose the correct dose and intramuscular route.
  • Overall, only 21% correctly recognized anaphylaxis and administered epinephrine appropriately.
  • Less experienced physicians ( < 5 years) showed better intramuscular epinephrine administration and gastrointestinal symptom recognition.

Conclusions:

  • Significant challenges exist in pediatricians' identification and management of anaphylaxis in simulated scenarios.
  • Despite selecting epinephrine, a substantial proportion demonstrate incorrect dosing or administration techniques.
  • Enhanced training is needed to improve anaphylaxis recognition and ensure correct emergency treatment protocols are followed.
Abstract

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