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Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?

Year 2022, Volume 44, Issue 1, 112 - 119, 14.01.2022
https://doi.org/10.20515/otd.960249

Abstract

Anaphylaxis is defined as a severe hypersensitivity reaction that can cause sudden onset and death. Therefore, it is vital that the diagnosis is made and the timely administration of epinephrine. In this study, it was aimed to determine the knowledge and attitudes of the physicians in Edirne city center regarding the diagnosis and treatment of anaphylaxis. The study was designed as cross sectional survey. Physicians were visited in their institutions. A written questionnaire was applied face-to-face and it included questions about diagnosis and management of anaphylaxis. A total of 347 physician agreed to participate in the study. 43.5% of the physicians did not read any literature, book chapters or guidelines about the diagnosis criteria. Only 16.7% of responders knew all sign and symptoms of anaphylaxis. Twenty eight percent of physicians knew that correct route and dose of epinephrine administration. Associated factors with the knowledge about correct dose and route of epinephrine administration were the number of encounters with anaphylaxis cases and presence of treatment scheme in the instutition; OR (95% CI) were 3.520 (1.879-6.593) and 1.961 (1.168-3.290) respectively. 45.5% of the responders knew that there are no absolute contraindications to administer epinephrine in the case of anaphylactic shock. The study revealed that, knowledge of physicians relating diagnosis, treatment and management of anaphylaxis is unsatisfactory in our city. We think that it would be beneficial to provide physicians with in-service training regarding the diagnosis and management of anaphylaxis.

References

  • 1. Lieberman P, Nicklas RA, Oppenheimer J, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol. 2010;126(3):477-80.
  • 2. Lieberman P, Camargo CA Jr, Bohlke K, et al. Epidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol. 2006;97(5):596-602.
  • 3. Simons FE, Ebisawa M, Sanchez-Borges M, et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J. 2015:28(1);8:32.
  • 4. Storey P, Fitzharris P. Adrenaline in anaphylaxis: over treatment in theory, under treatment in reality. Postgrad Med J. 2015;91(1071):1-2
  • 5. Cetinkaya F, Zubarioglu AU, Goktas S. Pediatricians' knowledge about recent advances in anaphylaxis treatment in Istanbul, Turkey. Turk J Pediatr. 2009;51(1):19-21.
  • 6. Baccioglu A, Yılmazel Ucar, E. Level of knowledge about anaphylaxis among health care providers. Tuberk Toraks. 2013;61(2):140-6.
  • 7. Krugman SD, Chiaramonte DR, Matsui EC. Diagnosis and management of food-induced anaphylaxis: a national survey of pediatricians. Pediatrics. 2006;118(3):e554-60.
  • 8. Wang J, Sicherer SH, Nowak-Wegrzyn A. Primary care physicians' approach to food-induced anaphylaxis: a survey. J Allergy Clin Immunol. 2004;114(3):689-91.
  • 9. Grossman SL, Baumann BM, Garcia Pena BM, et al. Anaphylaxis knowledge and practice preferences of pediatric emergency medicine physicians: a national survey. J Pediatr. 2013;163(3):841-6.
  • 10. Muraro A, Roberts G, Worm M, et al. Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014;69(8):1026-45.
  • 11. Bekdaş M, Dilek M, Açıkel E, et al. Knowledge regarding diagnosis and treatment of anaphylaxis of general practitioners and medical students. Pamukkale Medical Journal. 2014;7(3):202-8.
  • 12. Altman AM, Camargo CA, Jr., Simons FE, et al. Anaphylaxis in America: A national physician survey. J Allergy Clin Immunol. 2015;135(3):830-3.
  • 13. Sole D, Ivancevich JC, Cardona V. Knowledge of anaphylaxis among ibero-American physicians: results of the Ibero-American Online Survey for Physicians on the management and treatment of anaphylaxis (IOSPTA) -Latin American society of Allergy, Asthma & Immunology (LASAAI). J Investig Allergol Clin Immunol. 2013;23(6):441-3.
  • 14. Jose R, Clesham GJ. Survey of the use of epinephrine (adrenaline) for anaphylaxis by junior hospital doctors. Postgrad Med J. 2007;83(983):610-1.
  • 15. Ibrahim I, Chew BL, Zaw WW, et al. Knowledge of anaphylaxis among Emergency Department staff. Asia Pac Allergy. 2014;4(3):164-71.
  • 16. Celik V, Gokmirza Ozdemir P, Beken B, et al. Anaphylaxis management for dentists: Knowledge and preparedness. Asthma Allergy Immunol. 2020;18:133-41.
  • 17. Orhan F, Civelek E, Sahiner UM, et al. Anaphylaxis: Turkish National Guideline 2018. Asthma Allergy Immunol. 2018;16(Suppl 1):1-62.
  • 18. Derinoz O, Bakirtas A, Arga M, et al. Pediatricians manage anaphylaxis poorly regardless of episode severity. Pediatr Int. 2014;56(3),323-7.
  • 19. Simons FE, Ardusso LR, Bilo MB, et al. World allergy organization guidelines for the assessment and management of anaphylaxis. World Allergy Organ J. 2011;4(2):13-37.
  • 20. Kahveci R, Bostanci I, Dallar Y. The effect of an anaphylaxis guideline presentation on the knowledge level of residents. J Pak Med Assoc. 2012;62(2):102-6.
  • 21. Droste J, Narayan N. Hosipital doctors' knowledge of adrenaline (epinephrine) administration in anaphylaxis in adults is deficient: There is still need for significant improvment. Resuscitation. 2010;81(8):1057-8.

Farklı Düzey Sağlık Basamaklarında Çalışan Hekimlerin Anafilaksi Tanı ve Yönetimi ile İlgili Bilgi Düzeyleri

Year 2022, Volume 44, Issue 1, 112 - 119, 14.01.2022
https://doi.org/10.20515/otd.960249

Abstract

Anafilaksi, ani başlangıçlı ve ölüme neden olabilen ciddi bir aşırı duyarlılık reaksiyonu olarak tanımlanır. Bu nedenle tanının konulması ve epinefrinin zamanında uygulanması hayati önem taşımaktadır. Bu çalışmada Edirne il merkezindeki hekimlerin anafilaksi tanı ve tedavisine ilişkin bilgi ve tutumlarının belirlenmesi amaçlanmıştır. Çalışma, kesitsel araştırma olarak tasarlandı. Hekimler kurumlarında ziyaret edildi. Yüz yüze yazılı bir anket uygulandı. Anket anafilaksi tanı ve yönetimi ile ilgili soruları içeriyordu. Toplam 347 hekim çalışmaya katılmayı kabul etti. Hekimlerin toplam %43,5'i tanı kriterleri ile ilgili herhangi bir literatür, kitap bölümü veya kılavuz okumamıştı. Yanıt verenlerin yalnızca %16,7'si anafilaksinin tüm belirti ve semptomlarını biliyordu. Hekimlerin yüzde yirmi sekizi, epinefrin uygulamasının doğru yolunu ve dozunu biliyordu. Epinefrinin doğru dozu ve uygulama yolu bilgisi ile ilişkili faktörler; anafilaksi vakaları ile karşılaşma sayısı ve kurumda tedavi şemasının varlığı; OR (%95 GA) sırasıyla 3,520 (1,879-6,593) ve 1,96 (1,168-3,290) idi. Yanıt verenlerin %45,5’i, anafilaktik şok durumunda epinefrin uygulamak için mutlak kontrendikasyon olmadığını biliyordu. Çalışma, ilimizde anafilaksi tanı, tedavi ve yönetimine ilişkin hekimlerin bilgilerinin yetersiz olduğunu ortaya koymuştur. Anafilaksi tanı ve yönetimi konusunda hekimlere hizmet içi eğitim verilmesinin faydalı olacağını düşünmekteyiz.

References

  • 1. Lieberman P, Nicklas RA, Oppenheimer J, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol. 2010;126(3):477-80.
  • 2. Lieberman P, Camargo CA Jr, Bohlke K, et al. Epidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol. 2006;97(5):596-602.
  • 3. Simons FE, Ebisawa M, Sanchez-Borges M, et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J. 2015:28(1);8:32.
  • 4. Storey P, Fitzharris P. Adrenaline in anaphylaxis: over treatment in theory, under treatment in reality. Postgrad Med J. 2015;91(1071):1-2
  • 5. Cetinkaya F, Zubarioglu AU, Goktas S. Pediatricians' knowledge about recent advances in anaphylaxis treatment in Istanbul, Turkey. Turk J Pediatr. 2009;51(1):19-21.
  • 6. Baccioglu A, Yılmazel Ucar, E. Level of knowledge about anaphylaxis among health care providers. Tuberk Toraks. 2013;61(2):140-6.
  • 7. Krugman SD, Chiaramonte DR, Matsui EC. Diagnosis and management of food-induced anaphylaxis: a national survey of pediatricians. Pediatrics. 2006;118(3):e554-60.
  • 8. Wang J, Sicherer SH, Nowak-Wegrzyn A. Primary care physicians' approach to food-induced anaphylaxis: a survey. J Allergy Clin Immunol. 2004;114(3):689-91.
  • 9. Grossman SL, Baumann BM, Garcia Pena BM, et al. Anaphylaxis knowledge and practice preferences of pediatric emergency medicine physicians: a national survey. J Pediatr. 2013;163(3):841-6.
  • 10. Muraro A, Roberts G, Worm M, et al. Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014;69(8):1026-45.
  • 11. Bekdaş M, Dilek M, Açıkel E, et al. Knowledge regarding diagnosis and treatment of anaphylaxis of general practitioners and medical students. Pamukkale Medical Journal. 2014;7(3):202-8.
  • 12. Altman AM, Camargo CA, Jr., Simons FE, et al. Anaphylaxis in America: A national physician survey. J Allergy Clin Immunol. 2015;135(3):830-3.
  • 13. Sole D, Ivancevich JC, Cardona V. Knowledge of anaphylaxis among ibero-American physicians: results of the Ibero-American Online Survey for Physicians on the management and treatment of anaphylaxis (IOSPTA) -Latin American society of Allergy, Asthma & Immunology (LASAAI). J Investig Allergol Clin Immunol. 2013;23(6):441-3.
  • 14. Jose R, Clesham GJ. Survey of the use of epinephrine (adrenaline) for anaphylaxis by junior hospital doctors. Postgrad Med J. 2007;83(983):610-1.
  • 15. Ibrahim I, Chew BL, Zaw WW, et al. Knowledge of anaphylaxis among Emergency Department staff. Asia Pac Allergy. 2014;4(3):164-71.
  • 16. Celik V, Gokmirza Ozdemir P, Beken B, et al. Anaphylaxis management for dentists: Knowledge and preparedness. Asthma Allergy Immunol. 2020;18:133-41.
  • 17. Orhan F, Civelek E, Sahiner UM, et al. Anaphylaxis: Turkish National Guideline 2018. Asthma Allergy Immunol. 2018;16(Suppl 1):1-62.
  • 18. Derinoz O, Bakirtas A, Arga M, et al. Pediatricians manage anaphylaxis poorly regardless of episode severity. Pediatr Int. 2014;56(3),323-7.
  • 19. Simons FE, Ardusso LR, Bilo MB, et al. World allergy organization guidelines for the assessment and management of anaphylaxis. World Allergy Organ J. 2011;4(2):13-37.
  • 20. Kahveci R, Bostanci I, Dallar Y. The effect of an anaphylaxis guideline presentation on the knowledge level of residents. J Pak Med Assoc. 2012;62(2):102-6.
  • 21. Droste J, Narayan N. Hosipital doctors' knowledge of adrenaline (epinephrine) administration in anaphylaxis in adults is deficient: There is still need for significant improvment. Resuscitation. 2010;81(8):1057-8.

Details

Primary Language English
Subjects Health Care Sciences and Services
Journal Section ORİJİNAL MAKALE
Authors

Raif YILDIZ
TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0003-1636-1241
Türkiye


Pınar GÖKMİRZA ÖZDEMİR (Primary Author)
TRAKYA UNIVERSITY
0000-0002-8155-4210
Türkiye


Necdet SÜT
TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-6678-482X
Türkiye


Gülfer Mehtap YAZICIOĞLU
TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-9197-1344
Türkiye

Publication Date January 14, 2022
Published in Issue Year 2022, Volume 44, Issue 1

Cite

Bibtex @research article { otd960249, journal = {Osmangazi Tıp Dergisi}, issn = {1305-4953}, eissn = {2587-1579}, address = {}, publisher = {Eskişehir Osmangazi University}, year = {2022}, volume = {44}, pages = {112 - 119}, doi = {10.20515/otd.960249}, title = {Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?}, key = {cite}, author = {Yıldız, Raif and Süt, Necdet and Yazıcıoğlu, Gülfer Mehtap} }
APA Yıldız, R. , Gökmirza Özdemir, P. , Süt, N. & Yazıcıoğlu, G. M. (2022). Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis? . Osmangazi Tıp Dergisi , 44 (1) , 112-119 . DOI: 10.20515/otd.960249
MLA Yıldız, R. , Gökmirza Özdemir, P. , Süt, N. , Yazıcıoğlu, G. M. "Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?" . Osmangazi Tıp Dergisi 44 (2022 ): 112-119 <https://dergipark.org.tr/en/pub/otd/issue/66237/960249>
Chicago Yıldız, R. , Gökmirza Özdemir, P. , Süt, N. , Yazıcıoğlu, G. M. "Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?". Osmangazi Tıp Dergisi 44 (2022 ): 112-119
RIS TY - JOUR T1 - Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis? AU - Raif Yıldız , Pınar Gökmirza Özdemir , Necdet Süt , Gülfer Mehtap Yazıcıoğlu Y1 - 2022 PY - 2022 N1 - doi: 10.20515/otd.960249 DO - 10.20515/otd.960249 T2 - Osmangazi Tıp Dergisi JF - Journal JO - JOR SP - 112 EP - 119 VL - 44 IS - 1 SN - 1305-4953-2587-1579 M3 - doi: 10.20515/otd.960249 UR - https://doi.org/10.20515/otd.960249 Y2 - 2021 ER -
EndNote %0 Osmangazi Journal of Medicine Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis? %A Raif Yıldız , Pınar Gökmirza Özdemir , Necdet Süt , Gülfer Mehtap Yazıcıoğlu %T Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis? %D 2022 %J Osmangazi Tıp Dergisi %P 1305-4953-2587-1579 %V 44 %N 1 %R doi: 10.20515/otd.960249 %U 10.20515/otd.960249
ISNAD Yıldız, Raif , Gökmirza Özdemir, Pınar , Süt, Necdet , Yazıcıoğlu, Gülfer Mehtap . "Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?". Osmangazi Tıp Dergisi 44 / 1 (January 2022): 112-119 . https://doi.org/10.20515/otd.960249
AMA Yıldız R. , Gökmirza Özdemir P. , Süt N. , Yazıcıoğlu G. M. Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?. Osmangazi Tıp Dergisi. 2022; 44(1): 112-119.
Vancouver Yıldız R. , Gökmirza Özdemir P. , Süt N. , Yazıcıoğlu G. M. Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?. Osmangazi Tıp Dergisi. 2022; 44(1): 112-119.
IEEE R. Yıldız , P. Gökmirza Özdemir , N. Süt and G. M. Yazıcıoğlu , "Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?", Osmangazi Tıp Dergisi, vol. 44, no. 1, pp. 112-119, Jan. 2022, doi:10.20515/otd.960249

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