Community healthcare professionals lack knowledge on severe allergy symptoms in children, based on a recent study published within the journal, Clinical and Experimental Allergy.
School first aiders, community pharmacists and GP practice nurses overestimate the risk of fatal reaction for children with food hypersensitivity, suggests a new study, yet some are unable to treat allergy symptoms safely.
The team behind the study, from Imperial College London, asked 90 people (30 school first aiders, 30 GP practice nurses and 30 community pharmacists) to estimate the chance that a child having a food hypersensitivity will suffer a fatal allergic attack.
Researchers also asked how they would recognise and treat a life-threatening allergic attack in youngsters.
The results showed the 3 groups significantly overestimated the risk of a young child dying from a fatal allergic reaction.
However, despite heightened risk perception, the researchers found the research group were not able to adequately treat life-threatening allergy symptoms in children.
Most of the people surveyed in the study could not correctly administer an adrenaline auto-injector device for example EpiPen.
These life-saving devices, which look like a thick marker pen, must be used in a few minutes of a severe allergic attack. They inject adrenaline in to the body, which quickly reduces swelling within the throat and mouth, and allows breathing to return to normal.
One in three school first aiders were not able correctly make use of the device, which is usually pressed into the thigh.
More than eight in ten (83 per cent) GP nurses used the device incorrectly, along with three in five pharmacists.
Most from the study group previously said they were very confident in utilizing an adrenaline auto-injector.
The most common mistake ended up being to not contain the device in place for five seconds – the time needed for the adrenaline to move in to the thigh muscle. Other mistakes included not taking out the safety cap or trying to inject the wrong end into the leg. Many people might have accidently injected themselves.
The team said that although the study was small, the findings suggest all professionals who may need to treat severe allergies should have mandatory training, and practise with trainer devices regularly.
Heather Hanna, allergy research nurse as well as an author around the study on the Department of drugs at Imperial said: \”Although severe allergy symptoms are rare, they may be life-threatening. The results out of this study demonstrated that most of the professionals questioned over-estimated the risk of death from all of these reactions. However, this over-estimation didn't lead to people being better prepared – as only 40 per cent of individuals the research could correctly administer a trainer adrenaline auto-injector device.\”
The team said the findings surrounding school first aiders was particularly worrying, as previous studies have shown as much as 1 in 5 allergy symptoms in children occur in school. It’s also believed that connection between serious reactions might be worse when they occur in school as opposed to occurring in your own home.
Mrs Hanna added: \”There are great resources readily available for learning about treating allergy symptoms, as well as adrenaline auto-injector trainer devices. We advise people regularly practice using their trainer device.\”
Severe allergic reactions kill around one to two people per month in the UK. Most are triggered by a response to foods, such as peanuts, or to medicines. The reactions, called anaphylaxis, can quickly trigger swelling within the skin, lips, throat and mouth, making breathing difficult. They also result in a sudden drop in blood pressure level, resulting in a person becoming weak and floppy, and perhaps collapsing or losing consciousness.
Food allergies – most often nut allergy – are the leading cause of fatal anaphylaxis in children.
In the study, they gave the 90 study participants potential scenarios of the child suffering a hypersensitive reaction to food, after which asked them how they would respond.
They also asked the audience to inject a child mannequin by having an adrenaline auto-injector.
In the event of the severe allergic attack, an auto-injector ought to be given immediately – and then an ambulance ought to be called, and other medication may be given.
However, in the practise scenario under half of school first aiders said they'd give an auto-injector as first line treatment. A third said they'd give an inhaler first, and around 1 in 5 said they'd give antihistamines.
The findings echo previous research from Dr Robert Boyle, another author of the new study on the Department of drugs at Imperial. His previous work suggested over 1 / 2 of mothers of kids with severe allergies couldn't correctly administer an auto-injector, just six weeks after they received thorough training.
Dr Boyle said this stresses the need for better-designed devices.
\”These devices could be the distinction between life and death, yet their design isn't simple or intuitive enough for use in an emergency situation. We have to develop easier-to-use treating severe allergic reactions.\”
He also added that the risks related to allergy, particularly food hypersensitivity, ought to be included in information leaflets and training packages for professionals and patients, in order to avoid the heightened risk perception identified in this study.
“This misperception of risk by school first aiders, pharmacists and exercise nurses can lead to increased anxiety and restriction of activities for food-allergic children” said Dr Boyle.
Training regarding how to use adrenaline auto-injectors such as EpiPen will come in the UK through the Anaphylaxis Campaign's 'Allergywise' programme – http://www.anaphylaxis.org.uk/information-resources/allergywise-training/.