Conflict of interest: The authors declare no known competing or conflict of interest.
Treatment of a simulated child with anaphylaxis: An in situ two-arm study
Article first published online: 12 JUN 2013
© 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 7, pages 541–547, July 2013
How to Cite
O'Leary, F. M., Hokin, B., Enright, K. and Campbell, D. E. (2013), Treatment of a simulated child with anaphylaxis: An in situ two-arm study. Journal of Paediatrics and Child Health, 49: 541–547. doi: 10.1111/jpc.12276
- Issue published online: 11 JUL 2013
- Article first published online: 12 JUN 2013
- Manuscript Accepted: 19 FEB 2013
- patient simulation
This study aims to determine whether junior medical staff correctly identify and treat paediatric anaphylaxis and whether the presence or absence of hypotension influenced the treatment, using a standardised simulated patient encounter.
Junior medical staff from the emergency department of a large paediatric tertiary hospital were invited to participate in a two-armed cohort study to assess recognition and management of anaphylaxis in a standardised scenario using a simulated patient with and without hypotension. The primary outcome measure was administration of adrenaline. The secondary outcome measures included time to adrenaline administration, ability to seek and identify relevant features of history and clinical examination and use of other medications.
Fifty-six junior medical staff participated (90% participation rate). Only 50% of participants administered adrenaline in scenarios of definite anaphylaxis. Adrenaline was more likely to be administered if the scenario included hypotension, where the junior medical officer had previous formal resuscitation training (Advanced Paediatric Life Support) and by medical officers with more years of training.
Anaphylaxis is a life-threatening presentation and requires prompt recognition and appropriate adrenaline administration. Junior medical staff may require more emphasis on recognition and prompt adrenaline administration in both undergraduate and in hospital training and education. Simulated scenarios may provide a platform to deliver this training to ultimately improve patient care.