Treatment Of Anaphylaxis In Adults: A Questionnaire Survey At S. Nijalingappa Medical College Hospital, Bagalkot, India

摘要

Objective: To identify as to which medications medical students, interns and casualty medical officers are likely to prescribe when treating an adult patient with anaphylaxis, and to ascertain the dose and route of administration of adrenaline that they would use. Design: A questionnaire study survey. Setting: S. Nijalingappa Medical College (SNMC) and H.S.K. Hospital, Bagalkot (Bagalkot District) and public health centers (PHCs) of the Bagalkot district, Karnataka. Methods: The medical students, interns and casualty medical officers of the S.N.M.C and H.S.K. Hospitals and doctors of various grades, working at the public health centers of the Bagalkot district, were asked to anonymously complete a questionnaire detailing a hypothetical case of anaphylaxis. The data were collected from 52 second year medical students, 35 interns and 25 casualty medical officers. Main outcome measure: To determine the percentage of the use of adrenaline for the treatment of anaphylaxis in the correct dose, strength and route. Results: 90% of the participants said that they would give adrenaline as a first-line treatment to a patient with anaphylaxis, but only 38% knew the correct dose and route of administration. 52% of the doctors who were surveyed stated that they would give adrenaline by the intravenous (IV) route as the first-line treatment. 67.85% and 20.53% of the participants preferred to use corticosteroids and antihistamines respectively. 3.57% said that they would give antibiotics as second line drugs. Conclusion: Most of the doctors who were surveyed were not clear about the current anaphylaxis treatment guidelines. In particular, they were unsure of the recommended dose and route of the administration of adrenaline. This confusion applied to all medical students, interns and medical officers. To ensure that the first-line treatment of anaphylaxis is safe, we recommend that intramuscular (IM) adrenaline should be used in the majority of situations like anaphylaxis. We recommend that all doctors should receive regular education concerning the treatment of anaphylaxis.