Asia Pac Allergy.  2017 Jan;7(1):37-41. 10.5415/apallergy.2017.7.1.37.

Administration of the adrenaline auto-injector at the nursery/kindergarten/school in Western Japan

• Korematsu
• Fujitaka M
• Ogata M
• Zaitsu M
• Motomura C
• Kuzume K
• Toku Y
• Ikeda M
• Odajima H

• KMID: 2396912
• DOI: http://doi.org/10.5415/apallergy.2017.7.1.37

Abstract

BACKGROUND
In view of the increasing prevalence of food allergies, there has been an associated increase in frequency of situations requiring an emergency response for anaphylaxis at the home, childcare facilities and educational institutions.
OBJECTIVE
To clarify the situation of adrenaline auto-injector administration in nursery/kindergarten/school, we carried out a questionnaire survey on pediatric physicians in Western Japan.
METHODS
In 2015, self-reported questionnaires were mailed to 421 physicians who are members of the West Japan Research Society Pediatric Clinical Allergy and Shikoku Research Society Pediatric Clinical Allergy.
RESULTS
The response rate was 44% (185 physicians) where 160 physicians had a prescription registration for the adrenaline auto-injector. In the past year, 1,330 patients were prescribed the adrenaline auto-injector where 83 patients (6% of the prescribed patients) actually administered the adrenaline auto-injector, of which 14 patients (17% of the administered patients) self-administered the adrenaline auto-injector. "Guardians" at the nursery/kindergarten and elementary school were found to have administered the adrenaline auto-injector the most. Among 117 adrenaline auto-injector prescription-registered physicians, 79% had experienced nonadministration of adrenaline auto-injector at nursery/kindergarten/school when anaphylaxis has occurred. The most frequent reason cited for not administering the adrenaline auto-injector was "hesitation about the timing of administration."
CONCLUSION
If the adrenaline auto-injector was administered after the guardian arrived at the nursery/kindergarten/school, it may lead to delayed treatment of anaphylaxis in which symptoms develop in minutes. Education and cooperation among physicians and nursery/kindergarten/school staff will reduce the number of children suffering unfortunate outcomes due to anaphylaxis.

Keyword

Adrenaline auto-injector; Anaphylaxis; Nurseries; Kindergarten; Schools

MeSH Terms

Anaphylaxis
Child
Education
Emergencies
Epinephrine*
Food Hypersensitivity
Humans
Hypersensitivity
Japan*
Nurseries
Postal Service
Prescriptions
Prevalence
Epinephrine

Figure

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  Fig. 1 Response rates and background of the physicians. Responses (rate) were received from 185 physicians (44% of the number sent). One hundred sixty of the physicians were “registered as an insurance adrenaline auto-injector (AAI) prescribing physician,” while 25 were “nonregistered physicians.” The responses from registered AAI prescribing physicians are analyzed below.

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