Treatment of anaphylaxis in adults: results of a survey of doctors at Dunedin Hospital, New Zealand

Abstract

Aims: To identify which medications doctors would prescribe when treating an adult patient with anaphylaxis, and to ascertain the dose and route of administration of adrenaline they would use.

Method: Doctors of various grades working in a range of acute specialties at Dunedin Public Hospital (n=91) were asked to anonymously complete a questionnaire detailing two hypothetical cases of anaphylaxis.

Results: 92% of participants would give adrenaline as first-line treatment to a patient with anaphylaxis, but only 20% knew the correct dose and route of administration according to the New Zealand Resuscitation Council (NZRC) or local hospital formulary guidelines. 43% of doctors surveyed stated they would give adrenaline by the intravenous (IV) route as first-line treatment with 20% proposing a dose of 1 milligram or greater.

Conclusion: Most doctors surveyed were not clear about current anaphylaxis treatment guidelines. In particular, they were unsure of the recommended dose and route of administration of adrenaline. To ensure that the first-line treatment of anaphylaxis is safe, we recommend that intramuscular (IM) adrenaline should be used in the majority of situations in accordance with both NZRC and local hospital guidelines. We recommend that all doctors should receive regular education concerning the treatment of anaphylaxis.