Approaches of Surgical and Internal Branch Resident Physicians to Anaphylaxis

Özlem Deligöz; Ugur Altas

doi:10.36516/jocass.1255551

Research Article

Approaches of Surgical and Internal Branch Resident Physicians to Anaphylaxis

Year 2023, Volume: 6 Issue: 1, 116 - 123, 30.04.2023

Özlem Deligöz , Ugur Altas

https://doi.org/10.36516/jocass.1255551

Abstract

Aim:The aim of this study is to evaluate the level of knowledge about anaphylaxis among resident physicians working in a tertiary care hospital in Istanbul.
Materyal and Methods:Our descriptive study was conducted with resident physicians working in a tertiary hospital in Istanbul.A questionnaire including questions about the diagnosis and treatment of anaphylaxis was administered to physicians.
Results:172 resident physicians were surveyed within the scope of the study.While 47.0% (n=79) of the physicians were internal medicine residents, 53.0%(n=89) were surgical medicine residents. In terms of duration of employment in the profession, 76.2% (n=131) had a working period of 5 years or less.Median age was 29.0 years; minimum age was 25.0 years and maximum age was 53.0 years.All resident physicians felt that anaphylaxis could be life-threatening.The rate of those who correctly knew the clinical criteria for the diagnosis of anaphylaxis was 63.4% (n=109).The rate of those who knew that adrenaline was the first-line drug in the treatment of anaphylaxis was 95.9% (n=165).While 86.6% (n=149) of the physicians answered that adrenaline was administered intramuscularly, 70.0% (n=119) correctly answered the dose of adrenaline and 76.0% (n=130) correctly answered the name of the muscle where adrenaline was administered.The proportion of physicians who stated that anaphylaxis patients should be followed up for 24 to 72 hours was significantly higher in surgical branches (82.0%; n=73) than in internal branches (68.4%; n=54) (p<0.001).
Conclusion:The knowledge of resident physicians regarding anaphylaxis is not at a desired level. Trainings should be organized for physicians to increase their knowledge and awareness about anaphylaxis.

Keywords

Anaphylaxis, level of knowledge, physician assistants

References

1. Tarczoń I, Cichocka-Jarosz E, Knapp Aet al The 2020 update on anaphylaxis in paediatric population. Advances in Dermatology and Allergology. 2022;38(1). https://doi.org/10.5114/ada.2021.103327
2. Muraro A, Worm M, Alviani Cet al. EAACI guidelines: Anaphylaxis (2021 update). Allergy. 2022:77(2);357-77. https://doi.org/10.1111/all.15032
3. Bostancı İ, Doğru M. Anafilaksi ve anafilaksideki gelişmeler. Çocuk Dergisi. 2011;11(2):43-53.
4. Francuzik W, Ruëff F, Bauer A, et al. Phenotype and risk factors of venom-induced anaphylaxis: a case-control study of the European Anaphylaxis Registry. Journal of Allergy and Clinical Immunology. 2021;147(2):653-62. https://doi.org/10.1016/j.jaci.2020.06.008
5. Doğru M, Bostanci I, Özmen S, et al. The features of anaphylaxis cases followed in the pediatric allergy clinic. Güncel Pediatri. 2017;15(1):12-8. https://doi.org/10.4274/jcp.2017.0003
6. Grabenhenrich LB, Dölle S, Moneret-Vautrin A, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. Journal of allergy and clinical immunology. 2016;137(4):1128-37. https://doi.org/10.1016/j.jaci.2015.11.015
7. Worm M, Moneret‐Vautrin A, Scherer K, et al. First European data from the network of severe allergic reactions (NORA). Allergy. 2014;69(10): 1397-1404. https://doi.org/10.1111/all.12475
8. American Academy of Allergy, American College of Allergy, Joint Council of Allergy, Joint Task Force on Practice Parameters. Drug allergy: an updated practice parameter. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology, 2010;105(4):259-73. https://doi.org/10.1016/j.anai.2010.08.002
9. Ramsey NB, Guffey D, Anagnostou K, et al. Epidemiology of anaphylaxis in critically ill children in the United States and Canada. The Journal of Allergy and Clinical Immunology: In Practice. 2019;7(7):2241-49. https://doi.org/10.1016/j.jaip.2019.04.025
10. Wang Y, Allen KJ, Suaini NHet al. The global incidence and prevalence of anaphylaxis in children in the general population: a systematic review. Allergy. 2019;74(6):1063-80. https://doi.org/10.1111/all.13732
11. Maris I, Dölle‐Bierk, S, Renaudin JMet al. Peanut‐induced anaphylaxis in children and adolescents: data from the European Anaphylaxis Registry. Allergy. 2021;76(5):1517-27. https://doi.org/10.1111/all.14683
12. Sipahi S, Tamay ZÜ. Anafilaksiye Yaklaşım. Çocuk Dergisi. 2016;16(2):86-91.
13. Mustafa AR, Çocuklarda Anafilaksi'nin Tanı ve Tedavisine Güncel Yaklaşım. Klinik Tıp Pediatri Dergisi, 2011;10(2):18-26.
14. Özdemir S, Tosun B. Anafilaksi Ve Hemşirenin Sorumlulukları. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 30(1):140-152.
15. Cardona V, Ansotegui IJ, Ebisawa M, et al. World allergy organization anaphylaxis guidance 2020. World allergy organization journal. 2020;13(10): 100472. https://doi.org/10.1016/j.waojou.2020.100472
16. Giniş T, Toyran M, Civelek E, et al. Ankara ili aile hekimlerinin anafilaksi tanı ve tedavi yaklaşımlarının değerlendirilmesi: Olgularla anket çalışması. Asthma Allergy Immunology/Astim Allerji Immunoloji 2012;10(3).
17. Baççioğlu A, Yilmazel Uçar E. Level of knowledge about anaphylaxis among health care providers. Tuberk Toraks. 2013;61(2):140-6. https://doi.org/10.5578/tt.4812
18. Özkars MY. Anaflaksiye Aile Hekimlerinin Gözünden Bakış. Güncel Pediatri. 2019;17(1):34-44. https://doi.org/10.4274/jcp.2019.0003
19. Çekiç Ş, Canıtez Y, Karalı Z, et al. Tıp Fakültesi Son Sınıf Öğrencilerinin Anafilaksi Bilgi Düzeyleri. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2020;46(3):285-9. https://doi.org/10.32708/uutfd.773661
20. Özmen S, Aykan E, Çörüt N, et al. Üçüncü Basamak Sağlık Çalışanlarının Anafilaksi ve Adrenalin Oto-Enjektör Bilgi Düzeyleri. The Journal of Pediatric Research. 2015;(3):152-7. https://doi.org/10.4274/jpr.42714
21. Alsediq N. Level of knowledge of emergency room physicians about Paediatric Anaphylaxis guidelines for diagnosis and management: Findings from a cross-sectional study. Journal of Health Informatics in Developing Countries, 2020;14(2).
22. Yıldız R, Özdemir PG, Necdet ST, et al Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?. Osmangazi Tıp Dergisi. 2022; 44(1): 112-9.
23. Ibrahim I, Chew BL, Zaw WW, et al. Knowledge of anaphylaxis among Emergency Department staff. Asia Pacific Allergy. 2014;4(3):164-71. https://doi.org/10.5415/apallergy.2014.4.3.164
24. Güneş H, Özkars MY, ipek S. Pediatri Hemşirelerinin Anafilaksi Konusundaki Bilgi Düzeyi. Sürekli Tıp Eğitimi Dergisi. 2020;29(2): 118-30.
25. Tuncel T, Sancaklı O, Bag O, et al. Physicians' approach to anaphylaxis in childhood. Pediatric Emergency Care 2021;37(12):e1425-e1428.
26. Çeliksoy MH, Söğüt A, Topal E, et al. Aile hekimlerinin ilaç allerjilerine yaklaşımı. Asthma Allergy Immunology. 2014;12(2):91-6.
27. El-Sayed ZA, El-Owaidy R, Hussein SM, Hossam, Det al. Physicians' knowledge and practice concerning diagnosis and management of anaphylaxis: The situation in Egypt. African Journal of Emergency Medicine. 2021;11(4):464-70. https://doi.org/10.1016/j.afjem.2021.07.005
28. Ozkars MY, Yurttutan S. Drug Allergy and Anaphylaxis in Dentistry. Asthma Allergy Immunology/Astim Allerji Immunoloji. 2020;18(3):142-7. https://doi.org/10.21911/aai.520
29. Oflu AT. Anafilaksi. Kocatepe Tıp Dergisi. 2015;16(1):77-82. https://doi.org/10.18229/ktd.87939
30. Atakul G. Anafilaksi. Klinik Tıp Pediatri Dergisi. 2017;9(1):19-23.
31. Chaaban MR, Stuart J, Watley D, et al. Recurrent anaphylaxis in the United States: time of onset and risk factors. In International forum of allergy & rhinology. 2020;10;320-7. https://doi.org/10.1002/alr.22502
32. Aguilera A, O'Neill M, Slaven J, et al. Improving knowledge of epinephrine auto-injector use and peanut guidelines at an academic medical center. Journal of Allergy and Clinical Immunology. 2020;145(2):AB168. https://doi.org/10.1016/j.jaci.2019.12.347

Cerrahi ve Dahili Branş Asistan Hekimlerinin Anaflaksiye Yaklaşımları

Year 2023, Volume: 6 Issue: 1, 116 - 123, 30.04.2023

Özlem Deligöz , Ugur Altas

https://doi.org/10.36516/jocass.1255551

Abstract

Amaç: İstanbul’da üçüncü basamak bir hastanede çalışan asistan hekimlerin anafilaksi ile ilgili bilgi düzeylerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Tanımlayıcı tipte olan çalışmamız; İstanbul’da üçüncü basamak bir hastanede çalışan asistan hekimler ile yürütüldü. Hekimlere; anafilaksinin tanısı, tedavisi ile ilgili soruları içeren anket uygulandı. Çalışmada; hekimlerin yaşı, cinsiyeti, görev yaptıkları bölüm, meslekteki çalışma süreleri de değerlendirildi.
Bulgular: Çalışma kapsamında 172 asistan hekime anket uygulandı. Hekimlerin %47,0’si (n=79) dahili branş asistan doktoruyken; %53,0’ü (n=89) cerrahi branş asistan dokturuydu. Meslekteki çalışma süreleri değerlendirildiğinde %76,2’sinin (n=131) çalışma süresi 5 yıl ve altındaydı. Yaş medyan değeri 29,0 iken; minimum yaş 25,0 maksimum yaş 53,0 idi. Tamamı anafilaksinin hayatı tehdit edebileceğini düşünmekteydi. Anafilaksi teşhisi için klinik kriterleri doğru bilenlerin oranı ise %63,4 (n=109) idi. Anafilaksi tedavisinde ilk seçenek ilacın adrenalin olduğunu bilenlerin oranı %95,9 (n=165) idi. Hekimlerin %86,6 (n=149) adrenalinin intramüsküler yoldan uygulandığı cevabını verirken; %70,0 (n=119) adrenalinin dozunu, %76,0 (n=130) adrenalinin uygulandığı kasın adını doğru yanıtladı. Anafilaksi hastası 24-72 saat takip edilmelidir diyen hekimlerin oranı cerrahi branşlarda (%82,0; n=73) dahili branşlara göre anlamlı olarak daha yüksekti (%68,4; n=54) (p<0,001).
Sonuç: Asistan hekimlerin anafilaksi ile ilgili bilgileri yeteri kadar yüksek değildir. Hekimlere yönelik anafilaksi ile ilgili bilgi düzeyini ve farkındalığı arttıracak eğitimler düzenlenmelidir.

Keywords

Anafilaksi, asistan hekimler, bilgi düzeyi

References

1. Tarczoń I, Cichocka-Jarosz E, Knapp Aet al The 2020 update on anaphylaxis in paediatric population. Advances in Dermatology and Allergology. 2022;38(1). https://doi.org/10.5114/ada.2021.103327
2. Muraro A, Worm M, Alviani Cet al. EAACI guidelines: Anaphylaxis (2021 update). Allergy. 2022:77(2);357-77. https://doi.org/10.1111/all.15032
3. Bostancı İ, Doğru M. Anafilaksi ve anafilaksideki gelişmeler. Çocuk Dergisi. 2011;11(2):43-53.
4. Francuzik W, Ruëff F, Bauer A, et al. Phenotype and risk factors of venom-induced anaphylaxis: a case-control study of the European Anaphylaxis Registry. Journal of Allergy and Clinical Immunology. 2021;147(2):653-62. https://doi.org/10.1016/j.jaci.2020.06.008
5. Doğru M, Bostanci I, Özmen S, et al. The features of anaphylaxis cases followed in the pediatric allergy clinic. Güncel Pediatri. 2017;15(1):12-8. https://doi.org/10.4274/jcp.2017.0003
6. Grabenhenrich LB, Dölle S, Moneret-Vautrin A, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. Journal of allergy and clinical immunology. 2016;137(4):1128-37. https://doi.org/10.1016/j.jaci.2015.11.015
7. Worm M, Moneret‐Vautrin A, Scherer K, et al. First European data from the network of severe allergic reactions (NORA). Allergy. 2014;69(10): 1397-1404. https://doi.org/10.1111/all.12475
8. American Academy of Allergy, American College of Allergy, Joint Council of Allergy, Joint Task Force on Practice Parameters. Drug allergy: an updated practice parameter. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology, 2010;105(4):259-73. https://doi.org/10.1016/j.anai.2010.08.002
9. Ramsey NB, Guffey D, Anagnostou K, et al. Epidemiology of anaphylaxis in critically ill children in the United States and Canada. The Journal of Allergy and Clinical Immunology: In Practice. 2019;7(7):2241-49. https://doi.org/10.1016/j.jaip.2019.04.025
10. Wang Y, Allen KJ, Suaini NHet al. The global incidence and prevalence of anaphylaxis in children in the general population: a systematic review. Allergy. 2019;74(6):1063-80. https://doi.org/10.1111/all.13732
11. Maris I, Dölle‐Bierk, S, Renaudin JMet al. Peanut‐induced anaphylaxis in children and adolescents: data from the European Anaphylaxis Registry. Allergy. 2021;76(5):1517-27. https://doi.org/10.1111/all.14683
12. Sipahi S, Tamay ZÜ. Anafilaksiye Yaklaşım. Çocuk Dergisi. 2016;16(2):86-91.
13. Mustafa AR, Çocuklarda Anafilaksi'nin Tanı ve Tedavisine Güncel Yaklaşım. Klinik Tıp Pediatri Dergisi, 2011;10(2):18-26.
14. Özdemir S, Tosun B. Anafilaksi Ve Hemşirenin Sorumlulukları. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 30(1):140-152.
15. Cardona V, Ansotegui IJ, Ebisawa M, et al. World allergy organization anaphylaxis guidance 2020. World allergy organization journal. 2020;13(10): 100472. https://doi.org/10.1016/j.waojou.2020.100472
16. Giniş T, Toyran M, Civelek E, et al. Ankara ili aile hekimlerinin anafilaksi tanı ve tedavi yaklaşımlarının değerlendirilmesi: Olgularla anket çalışması. Asthma Allergy Immunology/Astim Allerji Immunoloji 2012;10(3).
17. Baççioğlu A, Yilmazel Uçar E. Level of knowledge about anaphylaxis among health care providers. Tuberk Toraks. 2013;61(2):140-6. https://doi.org/10.5578/tt.4812
18. Özkars MY. Anaflaksiye Aile Hekimlerinin Gözünden Bakış. Güncel Pediatri. 2019;17(1):34-44. https://doi.org/10.4274/jcp.2019.0003
19. Çekiç Ş, Canıtez Y, Karalı Z, et al. Tıp Fakültesi Son Sınıf Öğrencilerinin Anafilaksi Bilgi Düzeyleri. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2020;46(3):285-9. https://doi.org/10.32708/uutfd.773661
20. Özmen S, Aykan E, Çörüt N, et al. Üçüncü Basamak Sağlık Çalışanlarının Anafilaksi ve Adrenalin Oto-Enjektör Bilgi Düzeyleri. The Journal of Pediatric Research. 2015;(3):152-7. https://doi.org/10.4274/jpr.42714
21. Alsediq N. Level of knowledge of emergency room physicians about Paediatric Anaphylaxis guidelines for diagnosis and management: Findings from a cross-sectional study. Journal of Health Informatics in Developing Countries, 2020;14(2).
22. Yıldız R, Özdemir PG, Necdet ST, et al Physicians Working At Different Clinical Settings: Can They Recognize and Manage Anaphylaxis?. Osmangazi Tıp Dergisi. 2022; 44(1): 112-9.
23. Ibrahim I, Chew BL, Zaw WW, et al. Knowledge of anaphylaxis among Emergency Department staff. Asia Pacific Allergy. 2014;4(3):164-71. https://doi.org/10.5415/apallergy.2014.4.3.164
24. Güneş H, Özkars MY, ipek S. Pediatri Hemşirelerinin Anafilaksi Konusundaki Bilgi Düzeyi. Sürekli Tıp Eğitimi Dergisi. 2020;29(2): 118-30.
25. Tuncel T, Sancaklı O, Bag O, et al. Physicians' approach to anaphylaxis in childhood. Pediatric Emergency Care 2021;37(12):e1425-e1428.
26. Çeliksoy MH, Söğüt A, Topal E, et al. Aile hekimlerinin ilaç allerjilerine yaklaşımı. Asthma Allergy Immunology. 2014;12(2):91-6.
27. El-Sayed ZA, El-Owaidy R, Hussein SM, Hossam, Det al. Physicians' knowledge and practice concerning diagnosis and management of anaphylaxis: The situation in Egypt. African Journal of Emergency Medicine. 2021;11(4):464-70. https://doi.org/10.1016/j.afjem.2021.07.005
28. Ozkars MY, Yurttutan S. Drug Allergy and Anaphylaxis in Dentistry. Asthma Allergy Immunology/Astim Allerji Immunoloji. 2020;18(3):142-7. https://doi.org/10.21911/aai.520
29. Oflu AT. Anafilaksi. Kocatepe Tıp Dergisi. 2015;16(1):77-82. https://doi.org/10.18229/ktd.87939
30. Atakul G. Anafilaksi. Klinik Tıp Pediatri Dergisi. 2017;9(1):19-23.
31. Chaaban MR, Stuart J, Watley D, et al. Recurrent anaphylaxis in the United States: time of onset and risk factors. In International forum of allergy & rhinology. 2020;10;320-7. https://doi.org/10.1002/alr.22502
32. Aguilera A, O'Neill M, Slaven J, et al. Improving knowledge of epinephrine auto-injector use and peanut guidelines at an academic medical center. Journal of Allergy and Clinical Immunology. 2020;145(2):AB168. https://doi.org/10.1016/j.jaci.2019.12.347

There are 32 citations in total.

Details

Primary Language	English
Subjects	Surgery
Journal Section	Articles
Authors	Özlem Deligöz 0000-0002-5651-9827 Ugur Altas 0000-0001-5871-2033
Publication Date	April 30, 2023
Acceptance Date	March 9, 2023
Published in Issue	Year 2023 Volume: 6 Issue: 1

Cite

APA	Deligöz, Ö., & Altas, U. (2023). Approaches of Surgical and Internal Branch Resident Physicians to Anaphylaxis. Journal of Cukurova Anesthesia and Surgical Sciences, 6(1), 116-123. https://doi.org/10.36516/jocass.1255551

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