Santos Mae Jhelene L, Merrill Kaitlyn A, Ben-Shoshan Moshe, Gerdts Jennifer D, Giesbrecht Don, Lavine Elana, Prentice Susan, Upton Julia, Protudjer Jennifer L P
Department of Food and Human Nutritional Sciences, Faculty of Agriculture, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
The Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada.
Children (Basel). 2023 Jul 6;10(7):1175. doi: 10.3390/children10071175.
Anaphylaxis has occurred in preschools/schools yet there are no consistent food allergy (FA) management practices in early learning and childcare centres (ELCC) across jurisdictions. Presently, there are no reviews that have synthesized FA-related knowledge and management practices within ELCC. We aimed to perform a scoping review of FA management in ELCC, and report on perceived gaps or barriers. A PRISMA-ScR-guided search was conducted for North American, European and Australian articles in English/French in the OVID-MedLine, Scopus, and PsycInfo databases. Two independent reviewers screened the titles/abstracts of 2010 articles and full-text screened 77 articles; 15 of which were specifically related to ELCC. If the two reviewers could not agree to the relevance of a given study, a third reviewer provided guidance. This third reviewer also screened French articles. Thematic and descriptive reports of the studies were presented. We reported solely on pre-Coronavirus Disease pandemic ELCC studies. We included ten articles in this review, which provide evidence that ELCC staff have variable baseline knowledge, comprehension, experience, and practices in place to manage FA. ELCC staff also have limited FA-related training and experience regarding administration of epinephrine auto-injectors (EAI). Emergency Anaphylaxis Plans (EAP) were described in four studies. One study reported the parental influence on the site's food purchasing and FA management. Three studies provided educational interventions, which demonstrated increased and sustained FA-related knowledge and confidence post-intervention. Participants deemed the training beneficial and desired annual training and more FA resources to be available. Across jurisdictions, ELCC staff have provided care and administered EAI in emergencies, but training remained variable. Communication and care planning amongst ELCC staff, and parents, is crucial. Annual education, available EAI and EAPs are tools necessary for effectively managing emergencies.
过敏反应在幼儿园/学校时有发生，但各辖区的早期学习和儿童保育中心（ELCC）却没有一致的食物过敏（FA）管理做法。目前，尚无对ELCC内与FA相关的知识和管理做法进行综合总结的综述。我们旨在对ELCC中的FA管理进行范围综述，并报告所察觉到的差距或障碍。我们在OVID-MedLine、Scopus和PsycInfo数据库中，针对北美、欧洲和澳大利亚用英语/法语撰写的文章进行了PRISMA-ScR指导下的检索。两名独立评审员筛选了2010篇文章的标题/摘要，并对77篇文章进行了全文筛选；其中15篇与ELCC特别相关。如果两名评审员对某一特定研究的相关性无法达成一致，则由第三名评审员提供指导。该第三名评审员还筛选了法语文章。呈现了这些研究的主题和描述性报告。我们仅报告了冠状病毒病大流行之前的ELCC研究。我们在本综述中纳入了十篇文章，这些文章提供的证据表明，ELCC工作人员在管理FA方面的基线知识、理解、经验和做法各不相同。ELCC工作人员在肾上腺素自动注射器（EAI）给药方面的FA相关培训和经验也有限。四项研究描述了紧急过敏反应计划（EAP）。一项研究报告了家长对场所食品采购和FA管理的影响。三项研究提供了教育干预措施，这些措施表明干预后与FA相关的知识和信心有所增加且得以持续。参与者认为培训有益，并希望能有年度培训以及更多的FA相关资源。在各辖区，ELCC工作人员在紧急情况下提供了护理并使用了EAI，但培训情况仍然参差不齐。ELCC工作人员与家长之间的沟通和护理计划至关重要。年度教育、可用的EAI和EAP是有效管理紧急情况所需的工具。
