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Emergency Treatment of Anaphylactic Reactions in Air Rescue Missions: An Eight-Year Analysis of a German Rescue Helicopter Base

Published online by Cambridge University Press:  24 August 2021

Theresa Lakner Open the ORCID record for Theresa Lakner [Opens in a new window] ,
Mandy Cuevas ,
Marie-Luise Polk ,
Katja Petrowski  and
Mark Frank
Theresa Lakner*
Affiliation:
Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
Mandy Cuevas
Affiliation:
Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
Marie-Luise Polk
Affiliation:
Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
Katja Petrowski
Affiliation:
Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany Wissenschaftlicher Arbeitskreis der DRF Stiftung Luftrettung Gemeinnützige AG, Filderstadt, Germany
Mark Frank
Affiliation:
Wissenschaftlicher Arbeitskreis der DRF Stiftung Luftrettung Gemeinnützige AG, Filderstadt, Germany Department of Emergency Medicine, Municipal Hospital Dresden, Germany German Air Rescue gAG (DRF Stiftung Luftrettung gAG), Filderstadt, Germany
*
Correspondence: Theresa Lakner Department of Otorhinolaryngology Fetscherstraße 74, 01307 Dresden, Germany E-mail: [email protected]
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Abstract

Introduction:

Anaphylactic reactions can lead to a life-threatening situation. In the event of anaphylaxis, rapid and targeted emergency treatment is indicated.

Study Objective:

The study sought to determine the emergency therapy administered for anaphylaxis in children and adults. Focus was placed on therapy with adrenaline. In addition, the study aimed to investigate demographic data, triggers, and hospitalization rates of the different severities of anaphylaxis.

Methods:

A retrospective analysis of anaphylactic reactions was conducted using data from prehospital emergency missions performed by the Air Rescue Dresden/Germany from 2008 through 2015 using the standardized application protocol EPRO-5.0 (MIND 3) anonymized. Data from 152 adults and 29 children were evaluated, focusing especially on the acute treatment as well as demographic information, triggers, and symptoms of anaphylactic reactions.

Results:

In total, 152 adults (73 female, 79 male) from 18 to 87 years (mean 50.5 years) and 29 children (9 female, 20 male) from 1 to 16 years (mean 7.5 years) with anaphylactic reactions were analyzed. The most common trigger for severe anaphylactic reactions (Grade II-IV; classification modified according to Ring and Messmer) was food in children (33%) and insect venom in adults (59%). The data show that 19% of adults with Grade II-IV anaphylactic reactions (classification modified according to Ring and Messmer) received adrenaline. Regarding children, the appliance of adrenaline was only administered in seven percent of the cases of Grade II-IV anaphylactic reactions. Adults with Grade II or higher anaphylactic reactions were hospitalized in 92%. Three percent refused hospitalization and five percent were not transferred to hospital. One-hundred percent of the children with Grade II-IV anaphylaxis were hospitalized.

Conclusions:

Analysis of data from the Air Rescue Dresden/Germany shows that despite existing recommendations, only 19% of adults with severe anaphylaxis received adrenaline. Among children, only in seven percent was a treatment with adrenaline performed.

On the other hand, all patients survived the acute emergency treatment without apparent adverse outcomes. Thus, further studies are needed to determine the proper use of adrenaline in anaphylactic reactions.

Keywords

acute treatmentadrenalineanaphylactic reactionanaphylaxisemergency treatmentepinephrine
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 5 , October 2021 , pp. 586 - 592
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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