Rankin Kirsty E, Sheikh Aziz
Division of Community Health Sciences, General Practice Section, University of Edinburgh, Edinburgh, United Kingdom.
PLoS Med. 2006 Aug;3(8):e326. doi: 10.1371/journal.pmed.0030326.
The United Kingdom incidence of anaphylaxis has increased very sharply over the last decade, with the highest rates of hospital admissions occurring in school-aged children. This raises concerns about the extent to which schools are aware of approaches to the prevention and treatment of anaphylaxis.
We undertook a national postal survey of 250 Scottish schools enquiring about approaches to managing children considered to be at risk of anaphylaxis. We obtained responses from 148 (60%) schools, 90 (61%) of which reported having at least one at risk child. Most (80%) schools with children considered to be at risk reported having personalised care plans and invariably reported having at least one member of staff trained in the emergency treatment of anaphylaxis. Access to adrenaline was available on-site in 97% of these schools. However, significantly fewer schools without children considered to be at risk reported having a trained member of staff (48%, p < 0.001), with access to adrenaline being very poor (12%, p < 0.001). Overall, 59% of respondents did not feel confident in their school's ability to respond in an emergency situation.
Most schools with children considered to be at risk of anaphylaxis report using personal care plans and having a member of staff trained in the use of, and with access to, adrenaline. The picture is, however, less encouraging in schools without known at risk children, both in relation to staff training and access to adrenaline. The majority of schools with at risk children have poorly developed strategies for preventing food-triggered anaphylaxis reactions. There is a need for detailed national guidelines for all schools, which the Scottish Executive must now ensure are developed and implemented.
在过去十年中，英国过敏反应的发病率急剧上升，入院率最高的是学龄儿童。这引发了人们对学校对过敏反应预防和治疗方法的了解程度的担忧。
我们对250所苏格兰学校进行了全国性邮寄调查，询问对被认为有过敏反应风险儿童的管理方法。我们收到了148所（60%）学校的回复，其中90所（61%）报告称至少有一名风险儿童。大多数（80%）有被认为有风险儿童的学校报告有个性化护理计划，并且无一例外报告至少有一名工作人员接受过过敏反应紧急治疗的培训。在这些学校中，97%的学校现场可获取肾上腺素。然而，没有被认为有风险儿童的学校中，报告有经过培训的工作人员的显著较少（48%，p<0.001），可获取肾上腺素的情况也非常差（12%，p<0.001）。总体而言，59%的受访者对其学校在紧急情况下的应对能力没有信心。
大多数有被认为有过敏反应风险儿童的学校报告使用个性化护理计划，并配备有一名接受过肾上腺素使用培训且可获取肾上腺素的工作人员。然而，在没有已知风险儿童的学校中，无论是在工作人员培训还是获取肾上腺素方面，情况都不那么乐观。大多数有风险儿童的学校预防食物引发的过敏反应的策略不完善。需要为所有学校制定详细的国家指南，苏格兰行政部门现在必须确保这些指南得到制定和实施。
