title: Current Situation of Treatment for Anaphylaxis in a Japanese Pediatric Emergency Center.
abstract: OBJECTIVE
  Anaphylaxis is a systemic allergic reaction that sometimes requires prompt treatment with intramuscular adrenaline. The aim of the study was to investigate the current situation regarding anaphylaxis treatment in a representative pediatric primary emergency facility in Japan.
  
  
  METHODS
  We retrospectively examined the medical records dating from April 2011 through March 2014 from Kobe Children's Primary Emergency Medical Center, where general pediatricians work on a part-time basis. Clinical characteristics and current treatments for patients with anaphylaxis who presented to the facility were investigated. Furthermore, we compared the clinical characteristics between anaphylaxis patients given intramuscular adrenaline and those not given it.
  
  
  RESULTS
  During the study period, 217 patients were diagnosed with anaphylaxis. The median Sampson grade at the time of visit was 2, and 90 patients (41%) were grade 4 or higher. No patients received self-intramuscular injected adrenaline before arrival at our emergency medical center because none of the patients had been prescribed it. Further treatment during the visit was provided to 128 patients (59%), with only 17 (8%) receiving intramuscular adrenaline. Patients given intramuscular adrenaline had significantly lower peripheral saturation of oxygen at the visit (P = 0.025) and more frequent transfer to a referral hospital (P < 0.001) than those not given intramuscular adrenaline.
  
  
  CONCLUSIONS
  Education for Japanese pediatric practitioners and patients is warranted, because no patients used self-intramuscular injected adrenaline as a prehospital treatment for anaphylaxis, and only severely affected patients who needed oxygen therapy or hospitalization received intramuscular adrenaline in a pediatric primary emergency setting.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ninchoji
authors.forename: Sota
authors.initials: S
authors.lastname: Iwatani
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nishiyama
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kamiyoshi
authors.forename: Mariko
authors.initials: M
authors.lastname: Taniguchi-Ikeda
authors.forename: Naoya
authors.initials: N
authors.lastname: Morisada
authors.forename: Kazuto
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Iijima
authors.forename: Akihito
authors.initials: A
authors.lastname: Ishida
authors.forename: Ichiro
authors.initials: I
authors.lastname: Morioka
mesh_terms: D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000707:Anaphylaxis / Q000175:diagnosis / Q000188:drug therapy*; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D007564:Japan; D008297:Male; D012189:Retrospective Studies
chemical_list: D000316:Adrenergic alpha-Agonists; D004837:Epinephrine