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HK J Paediatr (New Series)
Vol 15. No. 3, 2010
HK J Paediatr (New Series) 2010;15:186-197

Original Article

Identifying the Service Gaps in the Management of Severe Systemic Allergic Reaction/Anaphylaxis by Paediatrics Departments of the Hospital Authority

MHK Ho, LM Wong, SC Ling, KP Lee, WW Cheng, J Hui, D Lau, KL Ng, D Wong, KL Kwok, EYW Kwan, on behalf of the Clinical Audit Working Group of the Quality Assurance Subcommittee in Paediatrics

Abstract

Background: Anaphylaxis and severe systemic allergic reaction are potentially life-threatening conditions. There is a paucity of data on the management of such condition amongst Hong Kong children. Objective: This review was designed to assist health professionals to evaluate the current process of care for children admitted with anaphylaxis or severe systemic allergic reaction, to identify service gaps so that patients are appropriately investigated, treated and taught how to recognise and manage severe allergic reactions. Methods: The anaphylaxis and severe allergic reaction/angioedema for children under age of 18 were identified using ICD-9 codes 995.0, 995.1, 995.6. We performed a retrospective chart review of one hundred children. We assessed the clinical practice among all Paediatric Departments within the Hospital Authority (HA) from January 2006 to December 2007. Results: The standardised admission rates of anaphylaxis aged below 18 years was 0.5 /100,000 (CI 0.6-0.7), which was probably 5-7 fold less compared with Western countries. This territory wide survey confirmed that food allergy was the leading cause in systemic allergic reactions amongst children admitted to HA service. Drug was the second commonest cause, accounting for 24% of the cases. The causes could not be determined in one out of six cases (17%). The attempt to identify the exact aetiologies was hampered by the lack of allergy assessment in most of the units. Adrenaline auto-injector was infrequently prescribed and used in our practice. Conclusion: This study provided background information for possible implementation of improvement measures that might be needed in the management of this possible life-threatening reaction.

Keyword : Anaphylaxis; Angioedema; Audit; EpiPen®; Hong Kong Children

Abstract in Chinese
  
 

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