Published online Mar 9, 2022. doi: 10.5409/wjcp.v11.i2.151
Peer-review started: April 13, 2021
First decision: July 27, 2021
Revised: August 2, 2021
Accepted: January 19, 2022
Article in press: January 19, 2022
Published online: March 9, 2022
Anaphylaxis is a life-threatening condition that develops as a reaction to exposure to an allergen which can be found in common foods such as cow's milk, egg, fish, and nuts in children. The use of an intramuscular adrenaline auto-injector (AAI) is considered the most essential treatment in these situations and parents and caregivers are always encouraged to carry this device for use in an emergency which commonly takes place in public places such as restaurants, schools, and parks, where medical staff are not guaranteed to be available. However, previous studies, in different settings, have reported underuse of the AAI by parents.
To explore the reasons for underutilisation of the AAI in our community.
A cohort of parents attending the paediatric allergy clinic at Al Ain Hospital in the United Arab Emirates completed a questionnaire survey aimed at assessing their understanding and knowledge of their child's allergy management, including their aptitude with the use of the AAI, as well as their competence and comfort in providing this treatment in an emergency.
Of 47 parents participating in the study, 39 were Emirati parents (83% and most parents who completed the survey were mothers (66%). As expected, food was the main cause of allergic reactions requiring prescription of the auto-injector device. Tree nuts and peanuts were noted to be the most common offending food in these children (62% and 38%, respectively). A doctor provided demonstrations and training on using the auto-injector device to 94% of the parents. More than two-thirds of the parents and caregivers (79%) were deemed knowledgeable on the indication for use of the device. Reluctance to administer the device was expressed by many of the parents, despite their satisfaction with the coaching they received on using the device in the study.
Ongoing coaching and teaching of parents on use of the AAI is paramount. However, this should be carried out together with psychological support to aid the parents to eliminate their hesitancy and acquire sufficient confidence in using the device when needed. Group teaching and sharing experiences is an excellent educational technique in a non-formal setting. Paediatric clinic play therapists can also have a role in needle phobia desensitisation for parents and children. More research is needed to explore the lack of empowerment and other reasons behind their fear and anxiety in using the device to plan effective interventions.
Core Tip: This is a retrospective study evaluating parents’ knowledge of the indications and use of adrenaline auto-injectors in children with anaphylaxis. The state of mind of parents towards the use of the device during anaphylactic episodes in terms of stress, anxiety, comfort, and confidence with the use of the adrenaline auto-injector (AAI) were also evaluated. The study concluded that training and education on how to use the AAI are important, but the psychological status of these parents should not be overlooked, and that sufficient psychological support should be provided in order to assist them to overcome stress and anxiety.