Meyran Daniel, Cassan Pascal, Nemeth Michael, Singletary Eunice, Raitt James, Djarv Therese, Carlson Jestin N
Healthcare, French Red Cross, Paris, FRA.
Prehospital Emergency Care, Bataillon De Marins Pompiers De Marseille, Marseille, FRA.
Cureus. 2023 Jul 8;15(7):e41547. doi: 10.7759/cureus.41547. eCollection 2023 Jul.
Early recognition of anaphylaxis is critical to early treatment and often occurs in the first aid setting. However, the ability of first aid providers to recognize anaphylaxis is unknown. We sought to examine the evidence regarding first aid providers' ability to recognize anaphylaxis. Our scoping review was performed as part of the International Liaison Committee on Resuscitation (ILCOR) continuous evidence evaluation processes to update the 2020 ILCOR Consensus on Science with Treatment Recommendations. We searched Medline, Embase, Cochrane, and the gray literature from 2010 to September 2022. The population included adults and children experiencing anaphylaxis with a description of any specific symptom to a first aid provider. Recognition of anaphylaxis was the primary outcome. Two investigators (DM and PC) reviewed abstracts and extracted and assessed the data. Discrepancies between the reviewers were resolved by discussion and consensus with the ILCOR First Aid Task Force. Out of 957 hits, 17 studies met inclusion criteria: one review and meta-analysis, two experimental studies, and 14 observational studies. We did not identify any studies that directly addressed our PICOST (Population, Intervention, Control, Outcomes, Study Design, and Timeframe) as none were performed in the first aid setting. Articles included individuals who may be first aid providers as patients and parents (n=5), teachers, students or school staff (n=8), caregivers and patients (n= 2) or nannies (n=1). All included studies were conducted in high-income countries. Our scoping review found that signs and symptoms of anaphylaxis were not specific and did not allow for easy identification by the first aid provider. Studies focused on education (n=10) and protocols (n=2) and found that both could have a positive impact on anaphylaxis recognition and management. While we did not identify any clinical studies that directly addressed the ability of first aid providers to identify anaphylaxis, future studies examining education methods and action plans may help improve the identification of anaphylaxis by first aid providers.
早期识别过敏反应对于早期治疗至关重要，且通常发生在急救场景中。然而，急救人员识别过敏反应的能力尚不清楚。我们试图研究关于急救人员识别过敏反应能力的证据。我们的范围综述是作为国际复苏联合委员会（ILCOR）持续证据评估过程的一部分进行的，以更新2020年ILCOR科学与治疗建议共识。我们检索了2010年至2022年9月的Medline、Embase、Cochrane以及灰色文献。研究对象包括向急救人员描述任何特定症状的发生过敏反应的成人和儿童。识别过敏反应是主要结局。两名研究人员（DM和PC）审查摘要并提取和评估数据。评审人员之间的差异通过与ILCOR急救工作组讨论并达成共识来解决。在957条检索结果中，17项研究符合纳入标准：1项综述和荟萃分析、2项实验研究以及14项观察性研究。我们未发现任何直接针对我们的PICOST（研究对象、干预措施、对照、结局、研究设计和时间范围）的研究，因为没有在急救场景中进行的研究。文章纳入的可能作为急救人员的个体包括患者及家长（n = 5）、教师、学生或学校工作人员（n = 8）、护理人员和患者（n = 2）或保姆（n = 1）。所有纳入研究均在高收入国家进行。我们的范围综述发现，过敏反应的体征和症状并不具有特异性，急救人员难以轻易识别。研究聚焦于教育（n = 10）和方案（n = 2），并发现两者都可能对过敏反应的识别和管理产生积极影响。虽然我们未发现任何直接探讨急救人员识别过敏反应能力的临床研究，但未来研究教育方法和行动计划可能有助于提高急救人员对过敏反应的识别能力。
