The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Management and educational status of adult anaphylaxis patients at emergency department

  • Kim, Mi-Yeong (Department of Internal Medicine, Inje University Busan Paik Hospital) ;
  • Park, Chan Sun (Department of Internal Medicine, Inje University Haeundae Paik Hospital) ;
  • Jeong, Jae-won (Department of Internal Medicine, Inje University Ilsan Paik Hospital)
  • Received : 2016.01.12
  • Accepted : 2017.08.01
  • Published : 2018.09.01
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Abstract

Background/Aims: We evaluated the management and educational status of adult anaphylaxis patients at emergency departments (EDs). Methods: Anaphylaxis patients who visited ED from 2011 to 2013 were enrolled from three hospitals. We analyzed clinical features, prior history of anaphylaxis, management and provided education for etiology and/or prevention. For analyzing associated factors with epinephrine injection, Pearson chi-square test was used by SPSS version 21 (IBM Co.). Results: A total of 194 anaphylaxis patients were enrolled. Ninety-nine patients (51%) visited ED by themselves. Time interval from symptom onset to ED visit was $62{\pm}70.5$ minutes. Drug (56.2%) was the most frequent cause of anaphylaxis. Forty-seven patients (24.2%) had prior history of anaphylaxis and 33 patients had same suspicious cause with current anaphylaxis. Cutaneous (88.7%) and respiratory (72.7%) symptoms were frequent. Hypotension was presented in 114 patients (58.8%). Mean observation time in ED was $12{\pm}25.7$ hours and epinephrine was injected in 114 patients (62%). In 68 patients, epinephrine was injected intramuscularly with mean dose of $0.3{\pm}0.10mg$. Associated factor with epinephrine injection was hypotension (p = 0.000). Twenty-three patients (13%) were educated about avoidance of suspicious agent. Epinephrine auto-injectors were prescribed only in five patients. Only 34 (19%) and 72 (40%) patients were consulted to allergist at ED and outpatient allergy department respectively. Conclusions: We suggested that management and education of anaphylaxis were not fully carried out in ED. An education and promotion program on anaphylaxis is needed for medical staff.

Keywords

References

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