title: Recognition, evaluation, and treatment of anaphylaxis in the child care setting.
abstract: BACKGROUND
  Anaphylaxis can occur anywhere. Many young children with a history of allergic reactions or anaphylaxis spend considerable time in child care centers. However, little is known about the centers' knowledge of, experience with, and capability to manage anaphylaxis.
  
  
  OBJECTIVE
  To evaluate the ability of child care centers to recognize, evaluate, and treat anaphylactic episodes in children aged 1 to 6 years.
  
  
  METHODS
  Eighty-five child care centers in the suburbs of Chicago were randomly selected. They were contacted by telephone and asked to participate in a study by completing an initial questionnaire. Center directors and teachers were then offered an allergy seminar addressing anaphylaxis avoidance, recognition, evaluation, and treatment. Center directors completed a questionnaire after the seminar.
  
  
  RESULTS
  Forty-four of the 85 centers contacted agreed to participate. Forty-two surveys were completed before the seminar and 39 after the seminar. On average, each center has up to 7 children with an identifiable food allergy. Information provided by the parents was the most commonly reported source of education concerning allergies. Before seminar completion, only 24% of child care centers would administer intramuscular epinephrine for a severe allergic reaction. After the seminar, 77% of centers stated that they would administer intramuscular epinephrine (P < .001). Also, center staff significantly improved their knowledge of typical allergy symptoms and of the correct method of intramuscular epinephrine administration.
  
  
  CONCLUSIONS
  There is a need for greater anaphylaxis education among child care providers. Our intervention significantly increased the ability of child care staff to recognize, evaluate, and treat anaphylaxis.
authors.affiliation: Department of Immunology and Microbiology, Rush University Medical Center, Chicago, Illinois, USA. priyabansal999@yahoo.com
authors.forename: Priya J
authors.initials: PJ
authors.lastname: Bansal
authors.forename: Rebecca
authors.initials: R
authors.lastname: Marsh
authors.forename: Bina
authors.initials: B
authors.lastname: Patel
authors.forename: Mary C
authors.initials: MC
authors.lastname: Tobin
mesh_terms: D000707:Anaphylaxis / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D004837:Epinephrine / Q000008:administration & dosage*; D005512:Food Hypersensitivity / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D011795:Surveys and Questionnaires
chemical_list: D004837:Epinephrine