Background

Anaphylaxis remains difficult to diagnose and epinephrine underused.

Objective

To better understand the thoughts of pediatricians regarding when acute allergic reactions constitute anaphylaxis and when epinephrine should be given by conducting an anonymous online survey.

Methods

The survey consisted of 8 case-based scenarios of allergic reactions with the following 2 questions on each case: (1) does this case represent anaphylaxis? and (2) if this patient immediately presented to you, would you treat the patient with epinephrine during the reaction?

Results

A total of 1001 responses were analyzed. When assessing all cases combined, there was discordance in whether a case represented anaphylaxis and administration of epinephrine was warranted in 8% of the cases. An average of 5% of all the respondents suggested that the case represented anaphylaxis but would not warrant epinephrine, whereas an average of 3% suggested that the case did not represent anaphylaxis but that epinephrine was warranted.

Conclusion

The results of this survey reveal that there is discordance among pediatricians on when an allergic reaction is considered anaphylaxis and when epinephrine is warranted. These data highlight the need for continued improvement of the definition of anaphylaxis and continued need for education regarding the diagnosis and management of anaphylaxis.

中文翻译：

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儿科医师对症状表现和急性过敏反应的看法

背景

过敏反应仍然难以诊断，肾上腺素未得到充分利用。

客观的

为了更好地理解儿科医生关于何时应构成急性过敏反应以及何时应给予肾上腺素的想法，应进行匿名在线调查。

方法

该调查包括8种基于病例的变态反应情景，每个病例均涉及以下2个问题：（1）此病例代表过敏反应吗？（2）如果该患者立即就诊，您在反应期间会用肾上腺素治疗该患者吗？

结果

总共分析了1001个响应。在评估所有合并病例时，在是否有过敏反应的病例中存在不一致之处，有8％的病例需要给予肾上腺素。平均所有受访者中有5％表示该病例代表过敏反应，但不能保证肾上腺素，而平均3％的受访者表示该病例不代表过敏反应，但需要肾上腺素。

结论

这项调查的结果表明，在什么时候认为过敏反应和何时需要肾上腺素，儿科医生之间存在分歧。这些数据强调了需要继续改善过敏反应的定义，并继续需要有关过敏反应的诊断和管理的教育。