G62(P) Managing anaphylaxis: From incident to improvement. (27th April 2016)

• Record Type: Journal Article
• Authors: Boyd, H; Sukhani, S; Muthumeenal, S; Noimark, L
• Is Part Of: Archives of disease in childhood. Volume 101(2016)Supplement 1
• Page Start: A35
• Page End: A35
• Publication Date: 2016-04-27
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2016-310863.59
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: Anaphylaxis is an acute emergency, and early treatment with adrenaline can be life-saving. Our hospital Trust performs food challenges on a weekly basis. Following a serious incident involving a case of anaphylaxis during an oral food challenge, we identified that recognition and management of anaphylaxis was poorly understood amongst many members of the multi-disciplinary paediatric team. Method: Baseline knowledge of anaphylaxis treatment was assessed amongst paediatric staff. Interventions were then implemented including a case presentation, high fidelity in situ simulation, posters highlighting recognition and management of anaphylaxis and review of trust guidelines. Post intervention, staff members were re-assessed on their knowledge of anaphylaxis and demonstration of Epipen use. Results: Baseline data captured 47 staff members. 74% could not identify correct dose of adrenaline required. 45% did not know the correct concentration and 6% did not know route of administration. Although 79% had previous knowledge of using an Epipen, in 71% a dose of adrenaline would not have been delivered. Following the interventions, 30 staff members were assessed. 100% correctly identified adrenaline as the first line treatment for anaphylaxis, 97% identified correct route of administration, 67% correct dose and 80% correct concentration of adrenaline. 87% questioned had attended a teaching session or seen the poster via email/distributed on the wards. 77% would have now successfully delivered a dose of adrenaline using the Epipen. Conclusion: Poor knowledge of anaphylaxis management amongst medical and nursing staff is prevalent, in particular around dosing and concentrations of adrenaline as well as correct use of Epipens, despite prior training. A serious clinical incident was a catalyst to improve recognition and management of anaphylaxis amongst the multi-disciplinary team using various educational interventions, now incorporated into junior doctor induction. We are exploring strategies to address unmet learning needs at a regional level.