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Evaluating the management of anaphylaxis in US emergency departments:Guidelines ***

World Journal of Emergency Medicine 2013年第2期4卷 98-106页

作者： W.Scott Russell Judith Rosen Farrar Richard Nowak Daniel P.Hays Natalie Schmitz Joseph Wood Judi Miller Pediatric Emergency Department Medical University of South CarolinaCharlestonSC 29425USA Life Sciences Press CanandaiguaNYUSA Department of Emergency Medicine Henry Ford Health SystemDetroitMIUSA University of Arizona Medical Center TucsonAZUSA DeKalb Medical Center AtlantaGAUSA Mayo Clinic Arizona ScottsdaleAZUSA SRxA WashingtonDCUSA

BACKGROUND:Anaphylaxis is characterized by acute episodes of potentially life-threatening symptoms that are often treated in the emergency *** guidelines recommend:1) quick diagnosis using standard criteria;2) first-line treatment with epinephrine;and 3) discharge with a prescription for an epinephrine auto-injector,written instructions regarding long-term management,and a referral(preferably,allergy) for ***,studies suggest low concordance with guideline recommendations by emergency medicine(EM) *** study aimed to evaluate how emergency departments(EDs) in the United States(US) manage anaphylaxis in relation to guideline ***:This was an online anonymous survey of a random sample of EM health providers in US ***:Data analysis included 207 EM *** respondent EDs,approximately 9%reported using agreed-upon clinical criteria to diagnose anaphylaxis;42%reported administering epinephrine in the ED for most anaphylaxis episodes;and <50%provided patients with a prescription for an epinephrine auto-injector and/or an allergist referral on *** provided some written materials,and follow-up with a primary care clinician was ***:This is the first cross-sectional survey to provide "real-world" data showing that practice in US EDs is discordant with current guideline recommendations for the diagnosis,treatment,and follow-up of patients with *** primary gaps are low(or no) utilization of standard criteria for defining anaphylaxis and inconsistent use of *** research is recommended.

关键词： Anaphylaxis Guidelines Epinephrine(adrenaline) Allergic reaction lifethreatening reaction Emergency department Epinephrine autoinjector Self-injectable epinephrine

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