Korean J Intern Med.  2018 Sep;33(5):1008-1015. 10.3904/kjim.2016.024.

Management and educational status of adult anaphylaxis patients at emergency department

• Kim MY
• Park CS
• Jeong JW

• KMID: 2420013
• DOI: http://doi.org/10.3904/kjim.2016.024

Abstract

BACKGROUND/AIMS
We evaluated the management and educational status of adult anaphylaxis patients at emergency departments (EDs).
METHODS
Anaphylaxis patients who visited ED from 2011 to 2013 were enrolled from three hospitals. We analyzed clinical features, prior history of anaphylaxis, management and provided education for etiology and/or prevention. For analyzing associated factors with epinephrine injection, Pearson chi-square test was used by SPSS version 21 (IBM Co.).
RESULTS
A total of 194 anaphylaxis patients were enrolled. Ninety-nine patients (51%) visited ED by themselves. Time interval from symptom onset to ED visit was 62 ± 70.5 minutes. Drug (56.2%) was the most frequent cause of anaphylaxis. Forty-seven patients (24.2%) had prior history of anaphylaxis and 33 patients had same suspicious cause with current anaphylaxis. Cutaneous (88.7%) and respiratory (72.7%) symptoms were frequent. Hypotension was presented in 114 patients (58.8%). Mean observation time in ED was 12 ± 25.7 hours and epinephrine was injected in 114 patients (62%). In 68 patients, epinephrine was injected intramuscularly with mean dose of 0.3 ± 0.10 mg. Associated factor with epinephrine injection was hypotension (p = 0.000). Twenty-three patients (13%) were educated about avoidance of suspicious agent. Epinephrine auto-injectors were prescribed only in five patients. Only 34 (19%) and 72 (40%) patients were consulted to allergist at ED and outpatient allergy department respectively.
CONCLUSIONS
We suggested that management and education of anaphylaxis were not fully carried out in ED. An education and promotion program on anaphylaxis is needed for medical staff.

Keyword

Patient care management; Education; Professional; Anaphylaxis; Emergency medical services

MeSH Terms

Adult*
Anaphylaxis*
Education
Educational Status*
Emergencies*
Emergency Medical Services
Emergency Service, Hospital*
Epinephrine
Humans
Hypersensitivity
Hypotension
Medical Staff
Outpatients
Patient Care Management
Epinephrine