The results of the evaluation of the international testing "Acute reactions in children" among doctors of various specialties

Abstract

BACKGROUND: Anaphylaxis is a situation of risk of death, so any doctor should be ready to identify its symptoms and provide emergency assistance. AIMS: This study is devoted to a comparative analysis of the level of knowledge on anaphylaxis in children among doctors of various specialties. MATERIALS AND METHODS: The study was conducted anonymously using an online questionnaire (Google platform) among 5 groups of doctors: allergologists-immunologists, resuscitators-anesthesiologists, emergency physicians, pediatricians and students of accredited university graduates. The questionnaire included 6 tasks on anaphylaxis in children and 4 tasks on other diseases similar to anaphylaxis, each had 2 questions (diagnosis and treatment) with three answer options, one was correct and gave 1 point. RESULTS: 1,871 respondents from 9 countries answered the tasks correctly. The average score of allergists on tasks of anaphylaxis was the highest (9 points out of 12) in comparison with other groups (p0.001). The average score on non-anaphylaxis tasks was high in all groups (7 points out of 8). The level of knowledge of respondents did not correlate with age and work experience. In the tasks of anaphylaxis, allergists made the appropriate diagnosis in 83.7% of cases, resuscitators, pediatricians and students - in 2/3, emergency physicians in 50%. For the treatment of anaphylaxis allergists prescribed epinephrine in 66.7% of cases, and other groups - in 50% or less. Percentage of correct answers in the tasks of food anaphylaxis (diagnosis) was the highest among allergists (80-96%), compared with other groups (36%-82%) (p0.001). In the treatment of food anaphylaxis, allergists prescribed epinephrine more often (up to 85%), compared with other groups (up to 77%). Percentage of correct responses of drug anaphylaxis (diagnosis and treatment) among all groups was high, but resuscitators responded better (94% and 64%, respectively). The level of knowledge on idiopathic anaphylaxis was the lowest in all groups. CONCLUSIONS: Underdiagnosis of anaphylaxis in children can reach 50%, but even with the correct diagnosis, epinephrine is not prescribed in half of the cases. It is necessary to increase and maintain the level of knowledge on anaphylaxis among doctors of various specialties, regardless of their length of service.