Survey of the use of epinephrine (adrenaline) for anaphylaxis by junior hospital doctors.
BACKGROUND
Anaphylaxis is a life threatening reaction where prompt and appropriate management can save lives. Epinephrine (adrenaline) is the treatment of choice; however, the recommended dose and route of administration of epinephrine used in the management of anaphylaxis is different from that used in the management of cardiac arrest.


OBJECTIVE
To investigate how junior doctors would administer epinephrine in a case of anaphylactic shock in an adult patient.


METHODS
Junior medical staff in two district general hospitals were assessed with a short questionnaire.


RESULTS
95 junior hospital doctors were assessed. The majority (94%) would administer epinephrine as the life saving drug of choice, but only 16.8% would administer it as recommended by the UK Resuscitation Council Guidelines.


CONCLUSIONS
Junior doctors may be called to make immediate management decisions in patients with anaphylaxis; however, widespread confusion exists regarding the dose and route of administration of epinephrine. Strategies to improve education and access to appropriate drugs are needed. A labelled "anaphylaxis box" on every resuscitation trolley, containing the dose of epinephrine with clear labelling for intramuscular use, may be one solution.
Jose
Ricardo
R
Department of Medicine, Broomfield Hospital, Chelmsford, UK. rjpj@ananzi.co.za
Clesham
Gerald J
GJ
D000279:Administration, Cutaneous; D000322:Adrenergic Agonists / Q000008:administration & dosage*; D000707:Anaphylaxis / Q000188:drug therapy*; D004739:England; D004837:Epinephrine / Q000008:administration & dosage*; D006767:Hospitals, District; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008505:Medical Staff, Hospital; D011364:Professional Practice; D014852:Wales