Details and effects of pre-hospital pharmacotherapy in pediatric population patients with anaphylactic or severe allergic symptoms – a single-center study

Introduction
Anaphylaxis is an acute, potentially life-threatening, systemic hypersensitivity reaction. Its prevalence in pediatric population is constantly increasing. Adrenaline is a first-line treatment in every case of anaphylaxis.

Aim
To examine the details of anaphylaxis treatment in the pre-hospital setting in a pediatric population. We wanted to determine whether there is a correlation between pharmacotherapy being implemented during the Emergency Medical Services (EMS) interventions and subsequent admission to the hospital.

Material and methods
In our retrospective study, we collected 2444 copies of the patients’ documents transferred by the EMS to the Emergency Department (ED) in the Pediatric Hospital in Warsaw throughout the calendar year 2020. The documents included demographic data, details of the given prehospital medication, and the initial diagnosis, among other information. Moreover, complementary data from the stay at the ED were added.

Results
Forty patients met the inclusion criteria, which was 1.64% of all the patients transported to the ED. Twenty-three (58%) patients received pharmacotherapy during pre-hospital emergency care (group A) while 17 (42%) did not receive it (group B). There was no significant difference in gender distribution between the groups. In group A there were 5 hospitalizations and in group B, 2 patients were admitted to the hospital (p > 0.05). The most common allergen was the food component (n = 22; 55%). Hydrocortisone was the most frequently used drug in pre-hospital care, being administered to 11 (48%) patients, with intramuscular adrenaline being given only 3 times (13%).

Conclusions
The gender of the patient did not influence the decision of whether pharmacotherapy should be implemented. Adrenaline is being underused in the prehospital treatment of severe allergic reactions. No correlation between the implementation of prehospital pharmacotherapy and subsequent hospitalization was found.