Department of Pediatrics, Division of Pulmonary, Allergy, Cystic Fibrosis, and Sleep Medicine, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Allergy Asthma Proc. 2011 Jul-Aug;32(4):295-300. doi: 10.2500/ajra.2011.32.3458.
Epinephrine is the treatment of choice for anaphylaxis. Delay in administration of epinephrine is a known risk factor for food allergy reaction-related mortality; however, individuals with food allergy may not have epinephrine readily available. This study was designed to determine the percent of food-allergic children that have an epinephrine autoinjector readily available and factors associated with epinephrine autoinjector carriage rates. Parents completed a questionnaire on food allergy and food allergy preparedness. Staff recorded whether an epinephrine autoinjector and medical alert bracelet was immediately available in clinic. Parental responses from 63 food-allergic children were included. Fifty-nine percent (37/63) had an epinephrine autoinjector present in the clinic, and 79% (50/63) reported receiving training in epinephrine autoinjector use. There was no correlation between epinephrine autoinjector presence in the clinic and parental report of having an epinephrine autoinjector available at all times (phi = 0.21). Epinephrine autoinjector training was associated with increased odds of having an epinephrine autoinjector immediately available (adjusted odds ratio, 8.74 [1.69, 45.04]). Fewer school aged children (≥5 years old) reportedly had their epinephrine autoinjector with them when eating lunch (25% [8/32] versus 42% [13/31]; p = 0.002) or snacks (28% [9/32] versus 37% [13/31]; p = 0.005) when compared with those <5 years old. Many children do not have their epinephrine autoinjectors readily available despite parental report. Epinephrine autoinjector training improved the odds of having an epinephrine autoinjector readily available. Continued patient education on the importance of having an epinephrine autoinjector easily accessible, especially when eating, is important.
肾上腺素是治疗过敏反应的首选药物。肾上腺素给药延迟是食物过敏反应相关死亡率的已知危险因素；然而，食物过敏患者可能无法随时获得肾上腺素。本研究旨在确定有多少食物过敏儿童随时可获得肾上腺素自动注射器，以及与肾上腺素自动注射器携带率相关的因素。父母填写了一份关于食物过敏和食物过敏准备情况的问卷。工作人员记录了在诊所是否可立即获得肾上腺素自动注射器和医疗警报手镯。纳入了 63 名食物过敏儿童的父母的回复。59%（37/63）的儿童在诊所中备有肾上腺素自动注射器，79%（50/63）的儿童报告接受过肾上腺素自动注射器使用培训。诊所中是否备有肾上腺素自动注射器与父母报告的随时可获得肾上腺素自动注射器之间没有相关性（phi = 0.21）。接受过肾上腺素自动注射器培训与更有可能立即获得肾上腺素自动注射器相关（调整后的优势比，8.74 [1.69, 45.04]）。当吃午餐或零食时，报告随身携带肾上腺素自动注射器的学龄儿童（≥5 岁）较少（25%[8/32]比 42%[13/31]；p = 0.002）或零食（28%[9/32]比 37%[13/31]；p = 0.005）与<5 岁的儿童相比。尽管父母报告称，许多儿童并未随时携带肾上腺素自动注射器。接受肾上腺素自动注射器培训可提高随时携带肾上腺素自动注射器的几率。持续向患者教育拥有易于获取的肾上腺素自动注射器的重要性，尤其是在进食时，这一点非常重要。
