Boulyana M
Arch Pediatr. 2013 Dec;20(12):1352-7. doi: 10.1016/j.arcped.2013.09.026.
Allergic emergencies in children are now more frequent and unpredictable and can cause death by anaphylactic shock, bronchospasm, and airway angioedema. Despite the publication of recent guidelines, many studies show that caregivers are still not at ease with the management of anaphylaxis and intramuscular administration of adrenaline. The prognosis depends on the early diagnosis of anaphylaxis and adrenaline administration before cardiorespiratory failure. The biphasic course of anaphylaxis requires systematic hospitalization of at least 6–24 hours depending on severity. To prevent recurrence, each child with anaphylaxis should permanently be in possession of two unexpired self-injectable adrenaline devices with a demonstration and written instructions on its use. Close collaboration between emergency departments, allergist, and family is essential to adapt therapeutic education and allergen avoidance to the allergen identified. This article focuses on opportunities to improve the skills of caregivers and standardize the management of anaphylaxis by proposing a practical definition and a therapeutic strategy based on Ring grading of severity.
儿童过敏性急症如今愈发频繁且难以预测，可因过敏性休克、支气管痉挛和气道血管性水肿导致死亡。尽管近期发布了相关指南，但许多研究表明，护理人员对过敏反应的管理及肾上腺素的肌肉注射仍感到不安。预后取决于过敏反应的早期诊断以及在心肺功能衰竭前给予肾上腺素。过敏反应的双相病程需要根据严重程度进行至少6至24小时的系统性住院治疗。为防止复发，每名过敏反应患儿都应始终备有两支未过期的自动注射肾上腺素装置，并配有使用说明和书面指导。急诊科、过敏症专科医生和家庭之间的密切合作对于根据所确定的过敏原调整治疗教育和避免接触过敏原至关重要。本文通过基于严重程度的林氏分级提出实用定义和治疗策略，重点探讨提高护理人员技能并规范过敏反应管理的机会。
