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Calls for better anaphylaxis training

Compiled by Vari Drennan, professor of healthcare and policy research, Kingston University and St. George’s, University of London.

Food allergies are relatively common in children and restrictions often affect quality of life. Fear of anaphylaxis is a concern for parents of food allergic children, leading to high levels of anxiety and overprotection.

High levels of anxiety are reported in parents who have a food allergic child. Picture: iStock

The risk of fatal anaphylaxis has been quantified as very low – approximately three micromorts (events per million person years) in those 0-19 years. This cross sectional survey investigated the knowledge of primary care professionals about the risk of fatal anaphylaxis from food allergies and in treating anaphylaxis.  

Thirty primary care nurses, 30 school first aiders and 30 community pharmacists from Westminster and Berkshire were recruited to the study. The survey included questions of estimation of risks. Participants also participated in practical assessments of skills in a simulated anaphylaxis situation. 


All three study groups significantly overestimated fatal anaphylaxis risk for a food allergic child by 13.5-fold. Participants reported themselves confident in using an adrenaline auto-injector (AAI) but only 41% were successful in the simulation.

The most common reasons for unsuccessful use were not removing the cap, not activating the AAI, using the wrong end to inject and not holding the AAI in place for five seconds.

Community health professionals need accurate knowledge of the risk of fatal anaphylaxis as well as practical skills in using AAI.

Hanna HJ, Emmanuel J, Naim S et al. (2016) Community healthcare professionals overestimate the risk of fatal anaphylaxis for food allergic children. Clin Exp Allergy. 46, 12, 1588-1595. doi: 10.1111/cea.12846.s.

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