Even Doctors Need More Education About Severe Allergic Reactions
When we visit the doctor, we place all our trust in that he or she can help us with our ailments. But doctors are human – one reason why they must continue their education even while in practice. One area of medicine that more primary doctors and emergency physicians need more knowledge is that of allergic reactions, particularly anaphylaxis treatment.
A survey of 318 physicians sponsored by the Asthma and Allergy Foundation of America (AAFA) found that there are many who do not know the correct ways to treat anaphylaxis and prevent recurrences. For example, a “substantial number” do not always provide epinephrine to patients whom they believe to be having such a reaction.
Epinephrine is the first line of treatment for patients suffering from anaphylaxis, a life-threatening allergic reaction with symptoms that include skin reactions (including hives and flushed or pale skin), a sensation of a lump in the throat, constriction of airways and swollen tongue or throat causing difficulty breathing, weak and rapid pulse, nausea or vomiting, and dizziness or fainting. A delay in using the drug is common in severe food allergic reaction deaths.
The survey population consisted of approximately 100 emergency room physicians, 100 allergists, 50 adult primary care physicians and 50 pediatricians. Between 82 and 99% of respondents in each group had treated at least one anaphylaxis case. However, the number of doctors treating anaphylaxis with epinephrine was not 100%. About 10% of the ER doctors and 20% of the primary care and pediatric physicians said they had either prescribed another drug, such as an antihistamine or steroid, sent the patient to a hospital, or completed an “other action”.
Surprisingly, not all (but most – 97%) of the allergists gave epinephrine to their patients.
Follow-up care for anaphylaxis patients was not consistent, the survey results found. The doctors may not always refer patients for follow-up care, in which they may receive an auto-injector, such as an Epi-Pen, for their home use. And only 60% of the ER physicians prescribed one themselves. One reason for this – some of the doctors mistakenly believe that some patients should never receive epinephrine.