Anaphylaxis, anaphylactoid reactions and anaphylactic shock are life- threatening acute inflammatory clinical conditions that result with a dramatic clinical response to external exposure and require emergent caution¹. Untreated or improperly treated reactions may lead to death^1,2. Early recognition and proper treatment are life saving^3,4.

Anaphylaxis is an emergent condition which may be encountered in daily practice of clinicians and that must be rapidly diagnosed and properly treated by a team approach^4,5. Our Rheumatology&Immunology Department organized an education program in cooperation with Anesthesiology and Reanimation Department. We prepared a questionnaire for nurses and doctors of other departments in order to determine their awareness of recent recommendations about anaphylaxis treatment.

A questionnaire including fourteen questions about anaphylaxis treatment was given to doctors and nurses working in different departments of Akdeniz University Hospital. The questionnaire consisted of questions regarding whether the participants treated a patient with anaphylaxis, reasons of anaphylaxis, drugs in use for treatment, adrenalin dose, administration routes and adrenalin preparations.

Mean age of the study group was 28,6±5,3 (41,7%male; 58,3% female). 300 questionnaires were given, 219 (73%) to doctors and 81(27%) to nurses. 67% of participants stated adrenalin as their first choice of drug to be administrated in anaphylaxis, while 22% preferred antihistamines and 10% corticosteroids. 75% of doctors and 34,5% of nurses preferred adrenalin as their first step treatment in anaphylaxis and 43% of study group said that they had seen and treated a patient with anaphylaxis. %90 of the participants told that they didn't know about the new adrenalin preparations. When the question was the administration route of adrenalin, 59,3% answered as intravenous route, 18,1% as intramuscular and 22,7% as subcutaneous. True dilution dose of adrenalin was stated by 29,7% of patients.

Important developments took place in routine for the treatment of anaphylaxis during last ten years^6,7. These developments are mainly reported in journals and meetings about allergy and immunology and we do not know whether medical staff from other departments is aware of the new recommendations. This study shows that many of the doctors and nurses do not have enough knowledge about these developments. We recommend that anaphylaxis treatment must be regularly presented to medical staff as a part of post-graduational education.

1) Haupt MT, Fujii TK, Carlson RW. Anaphylactic Reactions. Textbook of Critical Care (Editors: Grenvik A, Ayres SM, Holbrook PR, Shomaker WC) 4th edition, WB Saunders Comp. Philadelphia, 2000. p 246-258

2) Lieberman P, Camargo CA, Bohlke K, et al. Pidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy, Asthma Immunol 2006;97:596–602

3) Bjoraker DG. Anaphylaxis and Anaphylactoid Reactions. Complications in Anesthesia (Editors: Atlee JL) WB Saunders, Philadelphia, 1999. p 91-94

4) Anandan C, Simpson CR, Fischbacher C, Sheikh A. Exploiting the potential of routine data to better understand the disease burden posed by allergic disorders. Clin Exp Allergy 2006;36:866-871

5) Sheikh A, Alves B. Hospital admission for acute anaphylaxis: time trend study. BMJ 2000;320:1441–1444

6) Gupta R, Sheikh A, Strachan D, Anderson HR. Increasing hospital admission for systematic allergic disorders in England: analysis of national admission data. BMJ 2003;327:1142–1143

7) Walker S, Sheikh A. Managing anaphylaxis: effective emergency and long-term care are necessary. Clin Exp Allergy 2003;33:1015-1018