Assuntos
Alérgenos/efeitos adversos , Dermatite Atópica/etiologia , Alérgenos/classificação , Alergia e Imunologia , Animais , Criança , Pré-Escolar , Dermatite Atópica/epidemiologia , Dermatologia , Alimentos/efeitos adversos , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/etiologia , Departamentos Hospitalares , Hospitais Pediátricos , Humanos , Lactente , Ohio/epidemiologia , Hipersensibilidade a Amendoim/epidemiologia , Hipersensibilidade a Amendoim/etiologia , Pólen/efeitos adversos , Encaminhamento e Consulta , Estudos Retrospectivos , Testes Cutâneos , Centros de Atenção TerciáriaRESUMO
Patient group directions (PGDs) enable practitioners who are not independent prescribers to administer or supply patients with medications. They reduce delays in the administration of medication and thereby improve patients' journeys. This article discusses an audit of the use of PGDs in an emergency care centre to ensure that they are used appropriately and regularly.
Assuntos
Prescrições de Medicamentos/normas , Tratamento Farmacológico/normas , Enfermagem em Emergência/normas , Serviço Hospitalar de Emergência/organização & administração , Humanos , Educação de Pacientes como Assunto , Padrão de Cuidado , Reino UnidoRESUMO
Background: Oral food challenge (OFC) remains the criterion standard diagnostic procedure for food allergy. Although the need for OFCs has increased, some allergists may not perform them due to the risk for adverse events and lack of backup resources. Objective: The study aimed to elucidate the frequency of reactions in which emergency backup resources were used and reported on various challenge outcomes at a tertiary pediatric hospital. Methods: We retrospectively reviewed children and young adults (ages, 0-21 years) who completed OFCs in 2013-2018 at Cleveland Clinic Children's Hospital. Demographics, atopic history, culprit food, reaction history, and diagnostic testing as well as challenge details and outcomes were collected and analyzed. Results: A total of 1269 challenges of 812 unique patients ages 5 months to 21 years were reviewed. More than half of challenges were performed in patients with a history of a reaction and positive testing result before challenge. The foods with the highest proportion of allergic outcomes were egg, sesame, and baked egg. More than one-third of challenge reactions were grade 3 or 4 anaphylaxis when using a food-induced anaphylaxis grading scale. Epinephrine was used for reactions in 7.2% of all challenges. Reactions in five challenges (0.4%) prompted utilization of backup emergency resources. Conclusion: On review of nearly 1300 OFCs, emergency backup resources were rarely used, despite a large proportion of moderate-to-severe reactions. The need for backup resources during food challenges is rare, which suggests that most typical allergy offices are able to treat OFC reactions.