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Acute and preventive management of anaphylaxis in German primary school and kindergarten children

机译：德国小学和幼儿园儿童的过敏反应的急性和预防性处理

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Background Anaphylaxis is a severe, life-threatening situation. However, little is known about real-life anaphylactic management in children, especially in kindergarten and school settings, where a large number of anaphylaxes take place. Methods Parents, school teachers and child-care providers of 86 primary schools and kindergartens in the city of Dresden, Germany, received questionnaires to report their experience with anaphylaxis in children. The main foci of interest were symptoms, allergens, sites of occurrence, acute treatment and emergency sets. Results Out of 6352 returned questionnaires, 87 cases of anaphylaxis were identified. Prevalence was calculated at 1.5?%. Average age of the patients was 7?years, 58?% were boys. The majority of reactions occurred at home (67?%/58 children). Fourty seven percent (41 children) had recurrent episodes of anaphylaxis. Eighty two percent (71 children) showed cutaneous symptoms, 40?% (35 children) respiratory symptoms, 29?% (25 children) gastrointestinal symptoms, and 3.4?% (3 children) cardiovascular symptoms. Fourty seven percent were classified as mild reactions. Foods were the most common cause (60?%/52 cases). Out of these 52, tree-nuts (23?%/12 cases) and peanuts (16?%/8 cases) were the most frequent triggers. Sixty percent (52 cases) of reactions were treated by a physician, 35?% (30 cases) were treated by non-medical professionals only. Fifty one percent (44 children) received antihistamines, 37?% (32 children) corticosteroids, 1?% (1 child) intramuscular adrenaline. Sixty one percent of children (53 cases) received an emergency kit. Content were corticosteroids (70?%/37 cases) and antihistamines (62?%/33 cases). Adrenaline auto-injectors were prescribed to 26?% (14 cases). Concerning school and kindergarten-staff, 13?% of the child-care providers had no knowledge about the emergency kit’s content, compared to 34?% of teachers. Conclusions This study might support the impression of severe under-treatment of anaphylactic children in the use of adrenaline and prescription of incomplete equipped emergency sets. Knowledge of school and kindergarten staff must be improved through enhanced education.
机译：背景过敏反应是一种严重的，威胁生命的情况。但是，对于儿童的现实过敏性管理知之甚少，特别是在幼儿园和学校环境中，那里发生了大量过敏。方法德国德累斯顿市86所小学和幼儿园的父母，学校教师和儿童保育人员接受了问卷调查，以报告他们对儿童过敏反应的经历。感兴趣的主要焦点是症状，过敏原，发生部位，急性治疗和紧急情况。结果在6352份问卷中，发现过敏反应87例。患病率为1.5％。患者的平均年龄为7岁，男孩为58％。大多数反应发生在家里（67％/ 58名儿童）。 47％（41名儿童）有反复发作的过敏反应。 82％（71名儿童）出现皮肤症状，40％（35名儿童）呼吸道症状，29％（25名儿童）胃肠道症状，3.4％（3名儿童）心血管症状。 47％被归类为轻度反应。食物是最常见的原因（52％/ 52％）。在这52种中，最常见的诱因是坚果（12％/ 12例）和花生（16％/ 8例）。 60％（52例）的反应由医生治疗，35％（30例）的治疗仅由非医学专业人员进行。 51％（44名儿童）接受抗组胺药，37％（32名儿童）皮质类固醇，1％（1名儿童）肌内肾上腺素。百分之六十一的儿童（53例）获得了急救包。含量为皮质类固醇（70％/ 37例）和抗组胺药（62％/ 33例）。规定肾上腺素自动注射器的使用率为26％（14例）。关于学校和幼儿园工作人员，13％的托儿服务提供者不知道急救箱的内容，而教师的比率为34％。结论：本研究可能支持在使用肾上腺素和配药不全的急救药物的处方下严重过敏性儿童治疗不足的印象。必须通过加强教育来提高学校和幼儿园工作人员的知识。

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