Physicians Lack Understanding of How to Diagnose and Treat Anaphylaxis

An abstract presented at this month’s European Academy of Allergy and Clinical Immunology (EAACI) annual meeting in Prague provides a wake-up call for physicians: you don’t know anaphylaxis.

Anaphylaxis is a severe, life-threatening allergic reaction to a food, insect venom, or environmental substance.

But are physicians well versed in how to diagnose and treat anaphylaxis? A survey given to 840 physicians sought to provide answers.

Of the participants, 42% were specialists, 28.6% were residents and 29.9% were general practitioners.

In terms of recognizing and diagnosing anaphylaxis, the respondents were asked to identify common symptoms. Of the respondents:

• 90% of the participants identified skin involvement;
• 84% respiratory system involvement;
• 78% cardiovascular system involvement as anaphylaxis symptoms;
• Less than 50% correctly identified gastrointestinal system and upper respiratory tract involvement.

The implications are frightening: given the survey results, if a patient presented with acute gastrointestinal distress, coughing, and hoarseness, less than half of the responding physicians would consider anaphylaxis as a possibility.

Given the physician was able to correctly diagnose anaphylaxis, how many would know what to do? The participants were asked to identify appropriate treatment. Of the respondents:

• 83.3% of the participants correctly identified epinephrine as the first choice of treatment;
• 69.6% correctly marked injection as the route of administration of epinephrine;
• 76.4% correctly marked the application site of epinephrine;
• 61% of the participants correctly determined the adrenaline dose.

Only 48.7% of the respondents knew that there is no absolute contraindication for the use of epinephrine.

The study reveals the urgent need for physicians to be educated in the proper diagnosis and treatment of anaphylaxis as the sooner anaphylaxis is treated, the better the outcome. Missing such a diagnosis can put a patient in jeopardy of catastrophic consequences.

How to Determine Whether it’s Anaphylaxis