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Survey of the use of epinephrine (adrenaline) for anaphylaxis by junior hospital doctors

Department of Medicine, Broomfield Hospital, Chelmsford, UK

Correspondence to:
Correspondence to:
Dr Ricardo Jose
Broomfield Hospital, Court Road, Chelmsford CM1 7ET, UK; rjpj{at}ananzi.co.za

Background: Anaphylaxis is a life threatening reaction where prompt and appropriate management can save lives. Epinephrine (adrenaline) is the treatment of choice; however, the recommended dose and route of administration of epinephrine used in the management of anaphylaxis is different from that used in the management of cardiac arrest.

Objective: To investigate how junior doctors would administer epinephrine in a case of anaphylactic shock in an adult patient.

Methods: Junior medical staff in two district general hospitals were assessed with a short questionnaire.

Results: 95 junior hospital doctors were assessed. The majority (94%) would administer epinephrine as the life saving drug of choice, but only 16.8% would administer it as recommended by the UK Resuscitation Council Guidelines.

Conclusion: Junior doctors may be called to make immediate management decisions in patients with anaphylaxis; however, widespread confusion exists regarding the dose and route of administration of epinephrine. Strategies to improve education and access to appropriate drugs are needed. A labelled "anaphylaxis box" on every resuscitation trolley, containing the dose of epinephrine with clear labelling for intramuscular use, may be one solution.