Volume 4 Supplement 1

3rd Pediatric Allergy and Asthma Meeting (PAAM)

Open Access

PD30 - Management of pediatric anaphylaxis - comparison between a district general hospital (DGH) and a regional centre in UK

  • Srinivas Jyothi1,
  • Georgina Harlow2,
  • Anand Kanani1,
  • Manju Kannath1,
  • Arun Ghose1,
  • Julia Richardson2,
  • Nicola Dowling2 and
  • Nick Makwana2
Clinical and Translational Allergy20144(Suppl 1):P30

https://doi.org/10.1186/2045-7022-4-S1-P30

Published: 28 February 2014

Background

Anaphylaxis is a serious, life-threatening hypersensitivity reaction. The incidence of anaphylaxis is 4-5 per 100,000 persons per year and is reported to be increasing in recent years.

Aims

We analysed management of suspected anaphylaxis in children at a DGH and a regional referral center in UK.

Methods

A retrospective case note analysis was carried out between January 2007 and September 2012, which was compared to NICE (National Institute of Clinical Excellence) guidelines.

Results

We identified a total of 81 cases from the DGH of which 71 case notes were analysed and a total of 30 cases from the regional centre.
Table 1

Initial management

Initial Management

Percentage of children who received intervention (%)

 

DGH

Regional centre

Adrenaline IM(pre-hospital + in hospital)

66(33; 33)

70(16:54)

Antihistamines

89

60

Steroids

87

46

Oxygen

37

33

Fluids

17

10

Nebulised salbutamol

76

40

Table 2

Compliance with NICE guidelines on discharge

On discharge

Percentage of children (%)

 

DGH

Regional centre

Allergy clinic follow up planned

92

54

Issued with adrenaline auto injector

69

10

Documented training in auto injector use if given

73

13

Patients receiving discharge information about anaphylaxis

73

23

Patients receiving discharge information fulfilling the criteria stated by NICE

0

0

Both centers’ were good at documenting acute clinical features (>95%) and the circumstances prior to symptom onset (>93%). Both hospitals need to improve their documentation of time of onset of reaction (50:30%), informing about biphasic reaction (8.5- 1%) and supply information regarding support groups (1.4-0%). Our study revealed no child received full discharge information according to NICE criteria.

The DGH performed better than the tertiary center in referral to specialist allergy services providing adrenaline auto injector and demonstration of auto injector.

Conclusions

The DGH outperformed the tertiary center likely due to availability of specialist allergy services. We endeavor to improve our management by establishment of specialist allergy services at the tertiary hospital and anaphylaxis education among all doctors.

Authors’ Affiliations

(1)
Birmingham Children’s Hospital
(2)
City and Sandwell Hospital

Copyright

© Jyothi et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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