Klinik Araştırma
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Pediatri Asistanlarının Anafilaksi Yönetimi ve Adrenalin Otoenjektör Uygulama Becerileri Konusundaki Bilgi Düzeyleri: Eğitim Öncesi ve Eğitim Sonrası Değerlendirme

Yıl 2022, Cilt: 12 Sayı: 5, 789 - 793, 30.09.2022
https://doi.org/10.16899/jcm.1173798

Öz

Amaç: Çalışma, pediatri asistanlarının anafilaksi tedavisine ilişkin bilgi düzeylerini ve adrenalin otoenjektörünü (AOE) doğru uygulama becerisini değerlendirmek ve kısa süreli eğitimlerin bu düzeye katkısını belirlemek amacıyla yapılmıştır.
Gereç ve Yöntem: Anafilaksi tedavisi ile ilgili temel bilgileri değerlendirmek için bir anket formu dağıtıldı. Ve tüm katılımcılardan demo cihazları ve mankenler kullanarak AOE kullanımını göstermeleri istendi. Bu değerlendirme bir 'Ön Test' olarak kabul edildi. Eğitim sonunda AOE kullanım adımları yeniden değerlendirildi. Bu yeniden değerlendirme sonucunda elde edilen veriler “Son Test” olarak kaydedilmiştir.
Bulgular: Çalışmamıza toplam 110 pediatri asistanı dahil edildi. Katılımcıların çoğu (%94.6) anafilaksi tedavisinde uygulanacak ilk ilacın adrenalin olduğunu doğru olarak biliyordu. Ayrıca katılımcıların %99,4'ü adrenalin tedavisinin kas içine verilmesi gerektiğini biliyordu. Adrenalinin nereye uygulanacağı sorulduğunda, katılımcıların 94,6'sı doğru cevap vermiştir. AOE uygulama tekniği ön test ile değerlendirildiğinde; Bazı adımlarda sık sık hatalar yapıldığı gözlemlendi. Eğitim sonrasında uygulanan Son Test ile hemen hemen tüm katılımcılar adımları kusursuz bir şekilde tamamlayabilmiştir.
Sonuç: Hastaların poliklinik takiplerinde AOE uygulama tekniğini denetlemekle yükümlü hekimlerin bilgi düzeyinin artırılması, varsa hatalı adımların belirlenmesi ve eğitimlerinin tekrarlanması önemlidir.
Anahtar Kelimeler: Anafilaksi, adrenalin oto-enjektör, tedavi

Kaynakça

  • Poowuttikul P, Seth D. Anaphylaxis in Children and Adolescents. Pediatr Clin North Am 2019;66(5):995-1005.
  • 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.
  • Anafilaksi Türkiye Ulusal Rehberi. Cilt / Volume: 16, Supplement: 1, Nisan April, 2018. Available from: https://www.aid.org.tr/forms/rehberler/5-1 Anafilaksi%20T%C3%BCrk%20Ulusal%20Rehberi-2018.pdf
  • Warren CM, Zaslavsky JM, Kan K, Spergel JM , Gupta RS. Epinephrine auto-injector carriage and use practices among US children, adolescents, and adults. Ann Allergy Asthma Immunol 2018;121(4):479-89.e2..
  • Song TT, Worm M, Lieberman P. Anaphylaxis treatment: current barriers to adrenaline auto-injector use. Allergy 2014;69(8):983-91.
  • Ridolo E, Montagni M, Bonzano L, et al. How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients. Intern Emerg Med 2015;10(8):937-41.
  • Korematsu S, Fujitaka M, Ogata M, et al. Administration of the adrenaline auto-injector at the nursery/kindergarten/school in Western Japan. Asia Pac Allergy 2017;7(1):37-41.
  • Narchi H, Elghoudi A, Al Dhaheri K. Barriers and challenges affecting parents' use of adrenaline auto-injector in children with anaphylaxis. World J Clin Pediatr 2022;11(2):151-9.
  • El Turki A, Smith H, Llewellyn C, Jones CJ. A systematic review of patients', parents' and healthcare professionals' adrenaline auto-injector administration techniques. Emerg Med J 2017;34(6):403-16.
  • M Grouhi, M Alshehri, D Hummel, C M Roifman. Anaphylaxis and epinephrine auto-injector training: who will teach the teachers? J Allergy Clin Immunol 1999;104(1):190-3.
  • S H Sicherer, J A Forman, S A Noone. Use assessment of self-administered epinephrine among food-allergic children and pediatricians. Pediatrics 2000;105(2):359-62.
  • Peter D Arkwright, Alex J Farragher. Factors determining the ability of parents to effectively administer intramuscular adrenaline to food allergic children. Pediatr Allergy Immunol 2006;17(3):227-9.
  • Saleh-Langenberg J, Vries S, Bak E, Kollen JB, Flokstra-de BMJ, Dubois AEJ. Incomplete and incorrect epinephrine auto-injector training to food-allergic patients by pharmacists in the Netherlands. Pediatr Allergy Immunol 2017;28(3):238-44.
  • Kose SS, Asilsoy S, Tezcan D, ve ark. Is There an Optimal Training Interval to Improve the Correct Use of Adrenaline Auto-Injectors? Int Arch Allergy Immunol 2020;181(2):136-40.
  • Topal E, Bakirtas A, Yilmaz O, ve ark. When should we perform a repeat training on adrenaline auto-injector use for physician trainees? Allergol Immunopathol (Madr) 2014;42(5):472-5.
  • Ridolo E, Montagni M, Bonzano L, et al. How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients. Intern Emerg Med 2015;10(8):937-41.

Knowledge Levels of Pediatric Assistants on Anaphylaxis Management and Adrenaline Autoinjector Application Skills: Pretraining and Posttraining Evaluation

Yıl 2022, Cilt: 12 Sayı: 5, 789 - 793, 30.09.2022
https://doi.org/10.16899/jcm.1173798

Öz

Aim: The study aimed to evaluate the knowledge levels of pediatric residents about the treatment of anaphylaxis and the correct application skill of adrenaline auto-injector (AAI) and to determine the contribution of short-term training to this level.
Material and Method: A questionnaire form was distributed to evaluate the basic information about the anaphylaxis treatment. And, all participants were asked to demonstrate the use of AAI using demo devices and mannequins. This assessment was considered a ‘Pre-Test’. At the end of the training, the steps of AAI use were re-evaluated. The data coming from this re-evaluation were recorded as ‘Post-Test’.
Results: A total of 110 pediatric residents were included in our study. Most of the participants (94.6%) correctly knew that the first drug to be administered in the treatment of anaphylaxis was adrenaline. And also, 99.4% of the participants knew that adrenaline treatment should be administered intramuscularly. When asked where to apply adrenaline, 94.6 of the participants gave the correct answer. When the AAI application technique is evaluated with the pretest; It was observed that frequent mistakes were made in some steps. With the Post-Test applied after the training almost all the participants were able to complete the steps flawlessly
Conclusion: It is important to increase the knowledge level, identify faulty steps, if any, and repeat the training of physicians who are obliged to supervise the AAI application technique of patients during outpatient follow-ups.

Kaynakça

  • Poowuttikul P, Seth D. Anaphylaxis in Children and Adolescents. Pediatr Clin North Am 2019;66(5):995-1005.
  • 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.
  • Anafilaksi Türkiye Ulusal Rehberi. Cilt / Volume: 16, Supplement: 1, Nisan April, 2018. Available from: https://www.aid.org.tr/forms/rehberler/5-1 Anafilaksi%20T%C3%BCrk%20Ulusal%20Rehberi-2018.pdf
  • Warren CM, Zaslavsky JM, Kan K, Spergel JM , Gupta RS. Epinephrine auto-injector carriage and use practices among US children, adolescents, and adults. Ann Allergy Asthma Immunol 2018;121(4):479-89.e2..
  • Song TT, Worm M, Lieberman P. Anaphylaxis treatment: current barriers to adrenaline auto-injector use. Allergy 2014;69(8):983-91.
  • Ridolo E, Montagni M, Bonzano L, et al. How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients. Intern Emerg Med 2015;10(8):937-41.
  • Korematsu S, Fujitaka M, Ogata M, et al. Administration of the adrenaline auto-injector at the nursery/kindergarten/school in Western Japan. Asia Pac Allergy 2017;7(1):37-41.
  • Narchi H, Elghoudi A, Al Dhaheri K. Barriers and challenges affecting parents' use of adrenaline auto-injector in children with anaphylaxis. World J Clin Pediatr 2022;11(2):151-9.
  • El Turki A, Smith H, Llewellyn C, Jones CJ. A systematic review of patients', parents' and healthcare professionals' adrenaline auto-injector administration techniques. Emerg Med J 2017;34(6):403-16.
  • M Grouhi, M Alshehri, D Hummel, C M Roifman. Anaphylaxis and epinephrine auto-injector training: who will teach the teachers? J Allergy Clin Immunol 1999;104(1):190-3.
  • S H Sicherer, J A Forman, S A Noone. Use assessment of self-administered epinephrine among food-allergic children and pediatricians. Pediatrics 2000;105(2):359-62.
  • Peter D Arkwright, Alex J Farragher. Factors determining the ability of parents to effectively administer intramuscular adrenaline to food allergic children. Pediatr Allergy Immunol 2006;17(3):227-9.
  • Saleh-Langenberg J, Vries S, Bak E, Kollen JB, Flokstra-de BMJ, Dubois AEJ. Incomplete and incorrect epinephrine auto-injector training to food-allergic patients by pharmacists in the Netherlands. Pediatr Allergy Immunol 2017;28(3):238-44.
  • Kose SS, Asilsoy S, Tezcan D, ve ark. Is There an Optimal Training Interval to Improve the Correct Use of Adrenaline Auto-Injectors? Int Arch Allergy Immunol 2020;181(2):136-40.
  • Topal E, Bakirtas A, Yilmaz O, ve ark. When should we perform a repeat training on adrenaline auto-injector use for physician trainees? Allergol Immunopathol (Madr) 2014;42(5):472-5.
  • Ridolo E, Montagni M, Bonzano L, et al. How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients. Intern Emerg Med 2015;10(8):937-41.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Zeynep Sengul Emeksiz 0000-0001-7648-0352

Ahmet Alptuğ Güngör 0000-0002-7956-5826

Ali Can Demirel 0000-0002-3751-5046

Emine Dibek Mısırlıoğlu 0000-0002-3241-2005

Erken Görünüm Tarihi 11 Temmuz 2022
Yayımlanma Tarihi 30 Eylül 2022
Kabul Tarihi 25 Eylül 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 12 Sayı: 5

Kaynak Göster

AMA Sengul Emeksiz Z, Güngör AA, Demirel AC, Dibek Mısırlıoğlu E. Knowledge Levels of Pediatric Assistants on Anaphylaxis Management and Adrenaline Autoinjector Application Skills: Pretraining and Posttraining Evaluation. J Contemp Med. Eylül 2022;12(5):789-793. doi:10.16899/jcm.1173798