title: Correct recognition and management of anaphylaxis: not much change over a decade.
abstract: BACKGROUND
  Anaphylaxis is increasing in incidence. This potentially fatal condition requires immediate intramuscular adrenaline as a vital part of early treatment. A 2002 survey of UK Senior House Officers showed a lack of knowledge regarding the recognition and management of anaphylaxis. Since then major changes in medical education and updated national guidelines have aimed to ensure that doctors can recognise and treat anaphylaxis appropriately.
  
  
  OBJECTIVE
  To determine current knowledge concerning the recognition and management of anaphylaxis among junior doctors compared to their predecessors.
  
  
  METHODS
  Using the same methodology as in 2002, we asked 68 Foundation doctors to read five clinical scenarios potentially suggesting anaphylaxis and indicate how they would respond to each case. Their results were compared to those of Senior House Officers in 2002.
  
  
  RESULTS
  68 of 107 (64%) junior doctors completed the questionnaire. All recognised the need for adrenaline in anaphylaxis, but only 74% selected the correct intramuscular route, and 34% the correct route and dose. 82% of junior doctors would inappropriately give adrenaline to the patient who had inhaled a foreign body (case 2). A higher percentage of the 2013 cohort indicated the correct route and dose of adrenaline in anaphylaxis than their 2002 colleagues. However, a greater percentage also selected adrenaline treatment inappropriately in non-anaphylactic case scenarios.
  
  
  CONCLUSIONS
  Despite updated guidelines, junior doctors continue to have poor knowledge about the recognition and management of anaphylaxis, with some still considering inappropriate intravenous adrenaline. More effort should be given to the recognition of anaphylaxis in early medical training.
authors.affiliation: North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Plumb
authors.affiliation: North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Bright
authors.affiliation: North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Gompels
authors.affiliation: North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
authors.forename: David Joe
authors.initials: DJ
authors.lastname: Unsworth
mesh_terms: D000707:Anaphylaxis / Q000175:diagnosis* / Q000188:drug therapy*; D002983:Clinical Competence; D004638:Emergency Treatment / Q000379:methods* / Q000592:standards*; D004739:England; D004837:Epinephrine / Q000008:administration & dosage*; D006801:Humans; D007273:Injections, Intramuscular; D010820:Physicians / Q000592:standards*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine
keywords: IMMUNOLOGY; MEDICAL EDUCATION & TRAINING