The diagnosis and management of anaphylaxis practice parameter 2010 update

A total of surveys were collected from June to May A 12 item-questionnaire was applied Table 1 , which included the evaluation of the management of anaphylaxis. Demographic variables such as gender, age, place of residence, academic degree, years of work experience, and area of work were evaluated. To safeguard the security and confidentiality of the participants, the data were coded. Released Frequencies and percentages were reported for qualitative variables and measures of central tendency and dispersion for quantitative variables.

The distribution of the sample was evaluated by the Kolmogorov-Smirnov test. A total of surveys were evaluated; 10 participants did not accept the digital informed consent.

There were who met inclusion criteria and were included in the statistical analysis. The majority of participants were women They were analyzed by groups of years of work experience: 1—5 years with The group with the highest percentage of correct answers in the questionnaire were healthcare providers with more than 30 years of work experience Fig.

Of the surveys of healthcare providers, The remaining Table 3 , Fig. Medical students were the group with the highest percentage of correct answers in the questionnaire Fig. Most of the participants work in outpatient consult The average approved percentage of the survey by profession was Table 4.

A total of healthcare providers with a medical specialty participated: from Allergy and Immunology, from Pediatrics, 57 from Anesthesiology, 29 from Oncology, 21 from Internal Medicine, 11 from Emergencies, 10 from General Surgery, 6 from Hematology, and 2 from Intensive Therapy, resulting in a higher percentage approved of the survey by Allergy and Immunology specialists with Of the surveys, There were Based on the academic grade of the population, a significant difference was found in the proportions of questions 1—4 and 7— In question 2, the significant difference was marked by the groups of medical students and nurses, where the former had a higher proportion of correct answers Similarly, medical students yielded higher proportions of correct answers in question 3 No significant differences were found between the group's exam approval.

When divided by years of experience in their clinical field, significant differences between the groups was found in questions 1—2, 6—9, 11 and the proportion of the exam approval.

Finally, medical students presented higher proportions in correct answers in question 12 compared to physicians with 6—10 years of experience There was a significant difference between the proportions of approval between all specialty groups and in a post-hoc analysis, allergy and immunology specialists showed greater proportions of approval compared to general medicine practitioners Anaphylaxis is a serious allergic reaction and a condition that requires immediate initial treatment; delay in management can lead to fatal consequences.

Current guidelines for the management of anaphylaxis recommend the use of epinephrine as first-line treatment for anaphylaxis. In our study, the group with more than 30 years of experience as well as the medical students had a higher percentage of correct answers. These differences could be due to an increase in the number of publications on anaphylaxis in recent years, better clinical training, or the inclusion of the topic in conferences, academic sessions, and in the academic syllabus.

The staff responded that the treatment for anaphylaxis is epinephrine with Grossman et al 16 found that Most of the physicians in our study know that adrenaline is the first-line treatment for anaphylaxis, however some physicians do not.

We have to continue creating awareness in adrenaline use and the importance of not delaying it. Epinephrine has a rapid onset of action and acts at different levels: increasing cardiac output, blood pressure and reducing mucosal edema, reducing airway resistance and slowing the progression of the allergic reaction.

Although there are second- and third-line therapies such as corticosteroids and antihistamines, these treatments do not provide the benefits that adrenaline offers. Drupad et al 18 in , conducted a study on healthcare providers among medical students and nursing staff. Within the results, Olabarri et al 19 conducted a study on pediatric emergency care providers with a mean age of 28 years, and reported that They report that these physicians would refer these patients to a specialist in Allergy and Immunology in Pimental et al 20 reported specialist physicians: pediatrics, internal medicine, cardiology, anesthesiology, general surgery, orthopedics, and gynecology.

In Hypersensitivity reactions such as anaphylaxis are a public health problem, so strategies need to be planned to promote training for healthcare providers in the management of these reactions.

It is important that healthcare providers such as primary care physicians, medical students, nurses, dentists, emergency physicians, intensive care medical doctors, and anesthesiologists diagnose and treat anaphylaxis, and later refer them to specialists in Allergy and Clinical Immunology in order to make a personalized diagnosis and treatment.

The numerous barriers regarding the proper and timely identification of anaphylaxis remain a problem. The results observed in our study reinforce the need to increase all the necessary measures to improve the diffusion of clinical criteria in order to enhance the identification of the condition and to proceed with the treatment, especially in primary care physicians.

The authors declare that no funding was received for the present study. This study was approved by the clinical research ethics committee of the University Hospital and Faculty of Medicine of the Autonomous University of Nuevo Leon in Mexico before the initiation of this study.

Participants have signed written informed consent. MGC performed analysis and interpretation of results. All authors aided in interpreting the results and worked on the manuscript. All authors discussed the results and commented on the manuscript. All authors read and approved the final manuscript. Solensky, R; Khan, DA; et al. Drug allergy: An updated practice parameter. Ann Allergy Asthma Immunol e. The diagnosis and management of anaphylaxis practice parameter: update.

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