Treatment of anaphylaxis in adults: results of a survey of doctors at Dunedin Hospital, New Zealand.
OBJECTIVE
To identify which medications doctors would prescribe when treating an adult patient with anaphylaxis, and to ascertain the dose and route of administration of adrenaline they would use.


METHODS
Doctors of various grades working in a range of acute specialties at Dunedin Public Hospital (n=91) were asked to anonymously complete a questionnaire detailing two hypothetical cases of anaphylaxis.


RESULTS
92% of participants would give adrenaline as first-line treatment to a patient with anaphylaxis, but only 20% knew the correct dose and route of administration according to the New Zealand Resuscitation Council (NZRC) or local hospital formulary guidelines. 43% of doctors surveyed stated they would give adrenaline by the intravenous (IV) route as first-line treatment with 20% proposing a dose of 1 milligram or greater.


CONCLUSIONS
Most doctors surveyed were not clear about current anaphylaxis treatment guidelines. In particular, they were unsure of the recommended dose and route of administration of adrenaline. 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 in accordance with both NZRC and local hospital guidelines. We recommend that all doctors should receive regular education concerning the treatment of anaphylaxis.
Thain
Suzy
S
Dunedin Public Hospital, Dunedin. suzythain@hotmail.com
Rubython
Jill
J
D000280:Administration, Inhalation; D000420:Albuterol / Q000008:administration & dosage; D000707:Anaphylaxis / Q000188:drug therapy*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004837:Epinephrine / Q000008:administration & dosage*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D009520:New Zealand; D010353:Patient Education as Topic / Q000379:methods; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012646:Self Administration / Q000379:methods
D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D000420:Albuterol; D006854:Hydrocortisone; D004837:Epinephrine