What happens when the adrenaline rush is over?

Abstract

<h3>Background</h3> Anaphylaxis is a life-threatening condition that may recur. It is important to evaluate the potential precipitating allergens, provide education, appropriate treatment, training in medication administration and school care plans. Such focusing on “aftercare” on future management during an admission is important to reduce further anaphylaxis. <h3>Aims</h3> To evaluate the aftercare of children presenting with anaphylaxis (airway, breathing or cardiovascular compromise) and admitted to the paediatric ward. <h3>Methods</h3> Cases were identified from coding between 2005 to 2010 and were all analysed. We evaluated the main presenting complaint, treatment given (table 1) and aftercare provision given (table 2) including basic life support, watching Adrenaline Auto injector video, Adrenaline Auto injector training, provision of Epipen, informing school nurse, medic alert bracelet information, documentation of the provision of information provided to families and outpatient follow-up with a consultant with special interest in allergy. <h3>Results</h3> 29 children were admitted to the paediatric ward for further care. There was one death (medication reaction). Exposure to known allergen occurred in 16 (55%). The airway was involved in 17 (57%), breathing 25 (86%), circulation 11 (38%) and skin in 25 (86%). <h3>Conclusions</h3> Most children received adrenaline auto injectors and training although reasons for their apparent non provision in 35% is concerning. Follow-up in specialist outpatients did not occur in all cases. Our study will emphasise the importance of the care beyond the adrenaline.