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G57(P) Re-audit – the management and follow up of paediatric patients presenting with anaphylaxis to the emergency department 2012 vs 2014
  1. J Forshaw,
  2. C Fee,
  3. M Akthar
  1. Paediatric Department, King’s College Hospital, London, UK

Abstract

Aim To evaluate if children presenting to the Emergency Department (ED) with anaphylaxis were being managed as per Resuscitation Council and NICE guidelines. To see if following the 2012 audit improvements had been made.

Methods Children presenting with anaphylaxis to the ED were identified. The notes were then analysed using a data collection tool to assess what treatment, monitoring and follow up they received. The results were collated using Microsoft Excel and graphs were created. These were crossed compared to the results from the 2012 audit.

Results 90% (2014) vs 65% (2012) of identified children were given adrenaline, 100% vs 17% received antihistamine and 60% vs 69% received steroids. 80% were observed 6 h or less and only 2 admitted in 2014, compared to 47% observed over 8 h in 2012. At discharge 60% received adrenaline injectors in 2014 vs 80% in 2012. 90% were referred to allergy services vs 88%. 60% received patient education vs 80%. None of the identified children were told about biphasic reactions compared to 18% in 2012.

Conclusion The acute management of anaphylaxis had improved in 2014, and most children were appropriately monitored. However, there was poor adherance to the guidelines for observation time. Further management was another downfall – particularly patient education. Recommendations were made for doctors treating paediatric patients in ED to be aware of guidelines and of the Paediatric Allergy team during induction and for a discharge checklist to be included within the guidelines.

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