Level of knowledge of emergency room physicians about Paediatric Anaphylaxis guidelines for diagnosis and management: Findings from a cross-sectional study

Abstract

Introduction

Appropriate management of anaphylaxis is vital to save patients’ lives. However, the management of anaphylaxis can be daring for many reasons. Moreover, it has been found that anaphylaxis is inadequately diagnosed and managed in the hospitals of different countries of Middle East and Eastern Mediterranean, which might be due to the gaps in the knowledge, attitudes and practice preferences of Emergency Room (ER) physicians. Thus, we aimed to assess the level of knowledge and practice attitudes of ER physicians regarding anaphylaxis in some tertiary hospitals in Riyadh, capital of Saudi Arabia.

Methods

We undertook a cross-sectional survey of a convenience sample of all ER physicians working at three tertiary hospitals in Riyadh capital of the Kingdom of Saudi Arabia (KSA). A 20-item validated, and a structured questionnaire was used to collect the data. The study questionnaire was distributed to the physicians and 95 physicians responded to the study questionnaire in three hospitals. A descriptive and exploratory analysis was used to analyse the data.

Results

Of the total study participants, 76.8% were males and 39.6% had an experience of more than 10 years. More than a third and near to half of the physicians were aware of symptoms of anaphylaxis. Around 80.2% of the physicians showed a preference to give epinephrine to the patients when they arrived with anaphylaxis and 77.1% preferred the intramuscular route for administration of epinephrine in the thigh. Around 73.7% reported that they refer patients with anaphylaxis to an allergy specialist which is considered a proper follow-up. We only found a significant difference in the usage of epinephrine by different tertiary hospitals with a p-value of 0.027. We found a significant mean difference for the proper diagnosis of patients with anaphylaxis by gender (p-value: 0.035) and region for residency (p-value 0.037). However, we did not find any statistically significant difference regarding the management pathway at the ER regarding different types of the hospital (p-value: 0.162).

Conclusion

The study demonstrated that physicians of these three hospitals have basic knowledge regarding the management of anaphylaxis; however, strategies should be formulated to encourage the use of modern techniques such as the use of autoinjector. Educational programs for physicians and patients should be conducted. Further longitudinal studies with a large sample size should be conducted to build upon the findings of the current study.