Future doctors and anaphylaxis: What do they know? what should we do?

Future doctors and anaphylaxis: What do they know? what should we do?

Aim: Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction. Previous studies reveal that there aremany potential deficiencies in the knowledge of doctors regarding the diagnosis and management of anaphylaxis in different healthcare settings.The main purpose of this study was to assess the knowledge of 4th-6th-year medical students regarding the diagnosisand management of anaphylaxis.Material and Methods: The study was designed as a cross-sectional survey. The total number of 4th-, 5th-, and 6th-grade medicalstudents at Trakya University Medical School was 651, and 172 (26%) agreed to participate in the study. The participants wereasked to answer the questionnaire forms were including the questions assessing students’ knowledge about the diagnosis andmanagement of anaphylaxis, before and after a training session about anaphylaxis.Results:Awareness of students about symptoms indicating anaphylaxis other than cutaneous and respiratory symptoms wasbetween 40% and 77% in the initial test. Although the majority of participants (94%) chose epinephrine as the first-line drug for thetreatment of anaphylaxis, correct answers about dosage, concentration, and the route for administration of epinephrine were lowwhen compared with the final test (p < 0.001 for each item). While 14% stated they felt they could diagnose and treat anaphylaxis inthe initial test, this increased 83% after the training (p < 0.001).Conclusion: The study revealed that, knowledge of medical students relating diagnosis and treatment of anaphylaxis is unsatisfactory.Much more attention is needed in medical-school education concerning anaphylaxis management to prevent anaphylaxis-relatedmortalities in the future.

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  • 1. Tejedor Alonso MA, Moro Moro M, Múgica García MV. Epidemiology of anaphylaxis. Clin Exp Allergy 2015;45:1027-39.
  • 2. Lieberman P, Camargo CA Jr, Bohlke K, et al. Epidemiology of anaphylaxis: Findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol 2006;97:596-602.
  • 3. Simons FE, Ebisawa M, Sanchez-Borges M, et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J 2015:28;8:32.
  • 4. Altman AM, Camargo CA Jr, Simons FE, et al. Anaphylaxis in America: A national physician survey. J Allergy Clin Immunol 2015;135:830-3.
  • 5. Fineman S, Dowling P, O’Rourke D. Allergists’ selfreported adherence to anaphylaxis practice parameters and perceived barriers to care: an American College of Allergy, Asthma and Immunology member survey. Ann Allergy Asthma Immunol 2013;111:529-36.
  • 6. Krugman SD, Chiaramonte DR, Matsui EC. Diagnosis and management of foodinduced anaphylaxis: a national survey of pediatricians. Pediatrics 2006;118:554-60.
  • 7. Wang J, Sicherer SH, Nowak-Wegrzyn A. Primary care physicians’ approach to food-induced anaphylaxis: a survey. J Allergy ClinImmunol 2004;114:689-91.
  • 8. Grossman SL, Baumann BM, Garica Pena BM, et al. Anaphylaxis knowledge and practice preferences of pediatric emergency medicine physicians: a national survey. J Pediatr 2013;163:841-6.
  • 9. Worm M, Hompes S, Vogel N, et al. Care of anaphylaxis among practising doctors. Allergy 2008;63:1562-3.
  • 10. Cruz NV, Wilson BG, Fiocchi A, et al. America College of Allergy, Asthma and Immunology Adverse Reactions to Food Committee. Survey of physicians’ approach to food allergy, part 1: prevalence and manifestations. Ann Allergy Asthma Immunol 2007;99:325-33.
  • 11. Storey P, Fitzharris P. Adrenaline in anaphylaxis: over treatment in theory, under treatment in reality. Postgrad Med J 2015;91:1-2.
  • 12. Muraro A, Roberts G, Worm M, et al. EAACI Food Allergy and Anaphylaxis Guidelines Group. Anaphylaxis: Allergy 2014;69:1026-45.
  • 13. Jacobsen RC, Toy S, Bonham AJ, et al. Anaphylaxis knowledge among paramedics: results of a national survey. Prehosp Emerg Care 2012;16:527-34.
  • 14. Colleti Junior J, de Carvalho WB. Anaphylaxis knowledge among pediatric intensivists in Brazil: a multicenter survey. J Intensive Care Med 2017;32:593- 96.
  • 15. Rutkowski K, Dua S, Nasser S. Anaphylaxis: current state of knowledge for the modern physician. Post grad Med J 2012;88:458-64.
  • 16. Ibrahim I, Chew BL, Zaw WW, et al . Knowledge of anaphylaxis among emergency department staff. Asia Pacific Allergy 2014;4:164-71.
  • 17. Erkoçoğlu M, Civelek E, Azkur D, et al. Knowledge and attitudes of primary care physicians regarding food allergy and anaphylaxis in Turkey. Allergol Immunopathol (Madr) 2013;41:292-7.
  • 18. Baççioğlu A, YilmazelUçar E. Level of knowledge about anaphylaxis among health care providers. Tuberk Toraks 2013;61:140-6.
  • 19. Kahveci R, Bostanci I, Dallar Y. The effect of an anaphylaxis guideline presentation on the knowledge level of residents. J Pak Med Assoc 2012;62:102-6.
  • 20. Cetinkaya F, Zübarioğlu AU, Göktaş S. Pediatricians’ knowledge about recent advances in anaphylaxis treatment in Istanbul, Turkey. Turk J Pediatr 2009;51:19-21.
  • 21. Çetinkaya F, Sezgin G, Aslan OM. Dentists’ knowledge about anaphylaxis caused by local anaesthetics. Allergol Immunopathol (Madr) 2011;39:228-31.
  • 22. Drupad HS, Nagabushan H. Level of knowledge about anaphylaxis and its management among health care providers. Indian J Crit Care Med 2015;19:412-5
  • 23. Prabhu SB, Yasmeen M. Treatment of anaphylaxis in adults: A questionnaire survey at S. Nijalingappa medical college hospital, Bagalkot, India. J Clin Diagn Res 2010;4:3474-9.
  • 24. Adiga S, Nayak V, Bairy KL. Treatment of anaphylaxis in adults: a questionnaire survey. Online J Health Allied Sci 2008;7:6.
  • 25. Thain S, Rubython J. Treatment of anaphylaxis in adults: results of a survey of doctors at Dunedin Hospital, New Zealand. N Z Med J 2007;120:2492.
  • 26. Anchor J, Settipane RA. Appropriate use of epinephrine in anaphylaxis. Am J Emerg Med 2004;22:488-90. 27. Droste J, Narayan N. Anaphylaxis: Lack of hospital doctors’ knowledge of adrenaline (epinephrine) administration in adults could endanger patients’ safety. Eur Ann Allergy Clin Immunol 2012;44:122–7.
  • 28. Rudders SA, Banerji A, Corel B, et al. Multicenter study of repeat epinephrine treatments for food-related anaphylaxis. Pediatrics 2010;125:711-8.
  • 29. Gaeta TJ, Clark S, Pelletier AJ, et al. National study of US emergency department visits for acute allergic reactions, 1993 to 2004. Ann Allergy Asthma Immunol 2007;98:360-5.
  • 30. Russell S, Monroe K, Losek JD. Anaphylaxis management in the pediatric emergency department: opportunities for improvement. Pediatr Emerg Care 2010;26:71-6.
  • 31. Clark S, Bock SA, Gaeta TJ, et al. Multicenter study of emergency department visits for food allergies. J Allergy Clin Immunol 2004;113:347-52.
  • 32. Grabenhenrich L, Hompes S, Gough H, et al. Implementation of anaphylaxis management guidelines: a register-based study. PLoS One 2012;7:35778.
  • 33. Wood RA, Camargo CA, Lieberman P, et al. Anaphylaxis in America: The prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol 2013;133:461-7.
  • 34. Cohen MB, Saunders SS, Wise SK, et al. Pitfalls in the use of epinephrine for anaphylaxis: patient and provider opportunities for improvement. Int Forum Allergy Rhinol 2017;7:276-86.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
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