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Scott Med J. 2010 Aug;55(3):11-4.

Survey of anaphylaxis management by general practitioners in Scotland.

Author information

1
Department of Dermatology, Ninewells Hospital, Dundee, DD1 9SY, UK. grahamlowe@nhs.net

Abstract

AIM:

To obtain a snapshot of how patients with potentially life-threatening allergies are managed within a Primary Care setting.

METHODOLOGY:

A questionnaire-based survey sent to all General Practitioners in Scotland.

RESULTS:

Six hundred and thirteen replies were suitable for analysis. Ninety percent of respondents had prescribed adrenaline auto-injector pens, almost exclusively the EpiPen device. Less than half were personally confident in their use and only 17% had access to a dummy trainer pen for demonstration purposes. Twenty seven percent would prescribe one auto-injector only. Six percent reported accidental mis-firing of adrenaline pens, although with no serious sequelae. Refusal of pens by patients was noted by 1%. In the event of an anaphylactic emergency, 90% of respondents would use adrenaline as first-line treatment, although only half would use the UK Resuscitation Council recommended adult dose of 0.5mg by the intramuscular route (or 0.3mg by auto-injector). Eleven percent would give adrenaline by the slower subcutaneous route and 3% by the intravenous route. Thirty six percent had themselves treated such a case outside of hospital. Sixty two percent of respondents would seek specialist investigation of anaphylaxis, although only 31% felt that ready access was available. Frequent concerns were raised about current provision of care for patients with allergic disease and their own ability to deal with this.

CONCLUSION:

Investment is required, both to provide basic training and ongoing support for Primary healthcare staff in the management of allergic disease, and also for necessary accompanying specialist support.

PMID:
20795510
DOI:
10.1258/rsmsmj.55.3.11
[Indexed for MEDLINE]
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