Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Ann Allergy Asthma Immunol. 2010 May;104(5):405-12. doi: 10.1016/j.anai.2010.01.023.
The availability of anaphylaxis guidelines and of medications, supplies, and equipment for the assessment and management of anaphylaxis by allergy-immunology specialists in health care settings worldwide is unknown.
To ascertain the global availability of these essentials.
A survey instrument was developed and sent by e-mail in 2008 to a nonrandomized convenience sample of representative leading allergy-immunology specialists in 52 countries identified through the World Allergy Organization. Responses were analyzed by country.
Surveys were returned from 44 of 52 countries on 6 continents, for an 85% response rate. Anaphylaxis guidelines were reported to be in use in 70% of the 44 responding countries. The diagnosis of acute anaphylaxis was reported to be based on clinical history and physical examination alone in 63% of responding countries. Medications for anaphylaxis treatment were reported to be available in the 44 responding countries as follows: epinephrine (adrenaline) for injection, 100%; any intravenous glucocorticoid, 89%; any intravenous H1-antihistamine, 77%; any intravenous H2-antihistamine, 70%; glucagon, 73%; atropine, 73%; dopamine, 86%; noradrenaline, 70%; vasopressin, 64%; and a beta 2-agonist for nebulization, 86%. Supplies and equipment for anaphylaxis treatment were reported to be available in responding countries as follows: for giving supplemental oxygen, 95%; for intubation, 89%; for giving intravenous fluid resuscitation, 91%; for monitoring oxygenation using pulse oximetry, 91%; and for continuous noninvasive blood pressure and cardiac monitoring, 81%.
Allergy-immunology specialists reported that except for epinephrine ampules life-saving essentials for the assessment and management of anaphylaxis in health care settings were not universally available worldwide in 2008.
全球范围内，过敏-免疫专家在医疗环境中评估和管理过敏反应的过敏反应指南以及药物、用品和设备的可用性尚不清楚。
确定这些必需品的全球可用性。
2008 年，通过世界过敏组织确定的 52 个国家中具有代表性的领先过敏-免疫专家的非随机便利抽样，通过电子邮件发送了一份调查工具。按国家进行分析。
来自六大洲 44 个国家/地区的调查回复，回复率为 85%。报告称，44 个有回应的国家中有 70%使用过敏反应指南。在报告的 63%的国家中，急性过敏反应的诊断仅基于临床病史和体格检查。在 44 个有回应的国家中，报告称可获得过敏反应治疗药物如下：肾上腺素（肾上腺素）注射液，100%；任何静脉内糖皮质激素，89%；任何静脉内 H1 抗组胺药，77%；任何静脉内 H2 抗组胺药，70%；胰高血糖素，73%；阿托品，73%；多巴胺，86%；去甲肾上腺素，70%；血管加压素，64%；和β2-激动剂用于雾化吸入，86%。在有回应的国家中，报告称可获得过敏反应治疗用品和设备如下：用于给予补充氧气，95%；用于插管，89%；用于给予静脉补液复苏，91%；用于使用脉搏血氧饱和度监测氧合，91%；以及用于连续非侵入性血压和心脏监测，81%。
过敏-免疫专家报告称，2008 年，除了肾上腺素安瓿外，全球范围内医疗环境中评估和管理过敏反应的救命必需品并不普遍可用。
