Emergency department childhood anaphylaxis presentations in regional/remote Australia

Emergency department childhood anaphylaxis presentations in regional/remote Australia Journal Article

Journal of Paediatrics and Child Health

• Author(s): Weber, Heinrich C., Bassett, Gaylene L., Hollingsworth, Laura K., Gan, Vincent W. S., Rose, Samantha, Lim, Jacqueline, Prior, Sarah J.
• Published: 2022
• Publisher: John Wiley & Sons, Ltd
• ISBN: 1034-4810

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Abstract: Aim Explore the prevalence of childhood anaphylaxis and clinical presentation of anaphylaxis in children across two regional emergency departments over a 7-year period. Methods Retrospective audit of all children (0?18?years) presenting to emergency from 1 January 2010 to 31 December 2016 with anaphylaxis, defined by Australasian Society of Clinical Immunology and Allergy definitions and doctor diagnosis. Results Seven hundred and twenty-four patients were identified with allergic diagnosis, 60% were diagnosed with non-anaphylaxis allergic reactions or unspecified urticaria and 40% with anaphylaxis (n =?286). Annual prevalence of anaphylaxis remained stable over the study period (M =?30.9/10 000 cases, range: 20.8?48.3/10 000). Gender distribution was equal, median age was 9.48?years (interquartile range = 4?15). Most (71%) arrived by private transport. 23% had a prior history of anaphylaxis. Food triggers (44%) were the most common cause of anaphylaxis. Insect bites/stings triggers occurred in 21%. Patients were promptly assessed (average wait time = 13?min), 16% received prior adrenaline injections. Adrenaline was administered in 26% and 20% were admitted to hospital. On discharge, 29% had a follow-up plan, 9% received an allergy clinic referral, 6% anaphylaxis action plan, 26% adrenaline autoinjector prescriptions and allergy testing performed in 6%. Conclusions We found a relatively low prevalence of overall childhood anaphylaxis in a regional area. The two most common causes of anaphylaxis in this population (food and bites/stings) recorded increased prevalence providing an opportunity for further study. Significant gaps in evidence-based care of anaphylaxis were noted, demonstrating the need for improved recognition and treatment guideline implementation in regional areas.

• Urls: https://doi.org/10.1111/jpc.16006, https://onlinelibrary.wiley.com/doi/pdf/10.1111/jpc.16006
• Keywords: anaphylaxis, paediatric, regional/rural