PURPOSE OF THE STUDY.
The goal of this study was to assess pediatric emergency medicine physicians’ knowledge and practice preferences for anaphylaxis.
A cross-sectional sample was used with participants recruited by using contact information obtained from the American Board of Pediatrics and the American Board of Medical Specialties. Participants were given a 12-item survey.
A total of 1124 invitations were sent to the identified participants through SurveyMonkey. The survey included 12 questions covering demographic characteristics, physicians’ practices including medications preference, preferred route of epinephrine administration, duration of patient monitoring, discharge medications, prescription home with epinephrine autoinjectors, referral to specialists, and referral to educational Web sites. Emergency department settings were separated into university hospital, nonuniversity hospital with a residency training program, and community hospital with no residency training program. Data were collected by using the SurveyMonkey software.
Of the 1124 physicians, 56% responded, 3% opted out, and 0.9% no longer practiced medicine. The remaining did not respond. Overall, 93.5% correctly identified epinephrine as the treatment of choice for anaphylaxis but only 66.9% used the intramuscular route, which is the preferred method. Hospitals with residency programs had higher rates of intramuscular epinephrine use and higher volume of anaphylaxis cases, which in turn were associated with a decreased likelihood of admission for patients with anaphylaxis. In addition, 98.7% provided a prescription for an epinephrine autoinjector, 72.4% were referred to an allergy specialist, and 8.7% provided information to an educational Web site.
The majority of pediatric emergency medicine physicians reported using epinephrine for anaphylaxis but not all used the preferred route of administration.
This study highlights the improved progress of emergency physicians in appropriately using epinephrine during anaphylaxis, which was previously reported to be as low as 16%. However, the preferred intramuscular route of administration could be improved along with referral to allergy specialists and providing information to educational Web sites on anaphylaxis.
- Copyright © 2014 by the American Academy of Pediatrics