The advantages of prehospital severity classification of the anaphylaxis

Alihodžić, Hajriz

doi:10.5937/JRB1604006A

Akcije

dodaj u Moj izbor [0]

kako citirati ovaj članak
prikaži na oba jezika
podeli ovaj članak

Direktan link

Metrika

citati u SCIndeksu: 0
citati u CrossRef-u:0
citati u Google Scholaru:[]
posete u poslednjih 30 dana:7
preuzimanja u poslednjih 30 dana:5

Sadržaj

članak: 6 od 6

povratak na rezultate

Journal Resuscitatio Balcanica

2016, vol. 2, br. 4, str. 6-10

Prednosti prehospitalne klasifikacije težine anafilakije

Alihodžić Hajriz

Služba hitne medicinske pomoći, Tuzla, Bosna i Hercegovina

e-adresa: hajriz.a@hotmail.com

Ključne reči: anafilaksija; klasifikacija težine; kliničke dijagnoze; prehospitalno liječenje; ishod liječenja; anafilaksa; urgentna medicina; služba hitne medicinske pomoći

Sažetak

Uvod: U prehospitalnim uslovima adekvatna ocjena težine anafilaksije je uslov za odluku o primjeni lijekova koji mogu biti efikasni u toj mjeri da se anafilaksija za kratko vrijeme riješi kao klinički problem i spriječi njen razvoj do težeg stanja koje ugrožava život. Cilj istraživanja je bilo da se prikaže primjenljivost klasifikacija težine anafilaksije predložena od Müller i sar., u prehospitalnom lancu liječenja anafilaksije kao efikasne i jednoobrazne metode. Materijal i metode: Istraživanje je bilo prospektivno, jednogodišnje na području Tuzle. U prvoj grupi su ispitanici kod kojih je korištena klasifikacija težine koja je predložena od strane Müller i saradnika. Drugu grupu su činili svi bolesnici koji su liječenje imali u svim ambulantama Doma zdravlja u Tuzli, a odabrani su istim principom studije koju je objavila 2006. godine Američka Akademija za alergiju, astmu i imunologiju. Za uspjeh liječenja i efikasnost primjene klasifikacije težine anafilaksije koristili smo podatke o ishodu liječenja i mjestu definitivnog tretman ispitanika. Rezultati: Nakon prehospitalnog tretmana uspješno završen tretman anafilaksije korištenjem klasifikacije težine anafilaksije imalo je 35 bolesnika (77,8%). U ambulantama gdje se koristile kliničke dijagnoze prehospitalno završen tretman anafilaksije imalo je 10 bolesnika (24,4%). Šansu 3,5 puta veću imaju pacijenti liječeni u ambulantama da nakon prehospitalnog tretmana bude klinički tretirani i poslije završetka ambulantnog tretmana bez hospitalizacije vraćeni kući (OR: 3,5, 95% CI: 1,14-11,3, P=0,03). Šansa da pacijent bude hospitaliziran 5.1 puta veća je u grupi liječenih u ambulantama nego u grupi sa korištenjem klasifikacije težine anafilaksije (OR: 5,1, 95% CI: 1,29-29,2, P= 0,02). Zaključak: Prehospitalno završeno liječenje i registrovanje anafilaksije daje prednost korištenju klasifikacije težine anfilaksije kao metodi koja je pogodnija za uspješnije liječenje anafilaksije. Neophodno je u svim državama poboljšati način kako da zdravstveni profesionalci prepoznaju i liječe anafilaksiju, potrebno je kliničke kriterije za dijagnozu operacionalizirati kako bi imali svoju optimalnu efikasnost.

Abstract

Introduction: In prehospital settings, the adequate estimation of severity of the anaphylaxis is a precondition in treatment choice, with efficiency to improve the symptoms caused by anaphylaxis and to prevent it's further development which can lead to critical conditions. The aim of this research was to demonstrate the usefulness of classification of the severity of anaphylaxis suggested by Müller et al. in prehospital settings as effective and uniform method. Materials and methods: this was a prospective study, with the length of 1 year in county of Tuzla. In first group, there were patients classified by Müller et al. and in the other group was including patients who has been treated in all primary health care units in Tuzla. They has been chose according to the principle of the study set by American Academy for allergy, asthma and immunology conducted in 2006. As the indicator of effectiveness and success of treatment we used the data of final treatment outcomes. For the success of treatment and the efficacy of severity classifications of anaphylaxis, we used data on the outcome of treatment and definitive treatment of the observed ones. Results: After the pre-hospital treatment successfully completed treatment of anaphylaxis using severity classification of anaphylaxis had 35 patients (77.8%). For clinical diagnosis in prehospital treatment of anaphylaxis had 10 patients (24.4%). 3.5 times greater chance had patients after the pre-hospital treatment to be clinically treated, and returned home without hospitalization (OR: 3.5, 95% CI: 1.14 to 11.3, P = 0, 03). The chance of a patient being hospitalized 5.1 times higher in the group treated where severity classification of anaphylaxis has not been used (OR: 5.1, 95% CI: 1.29 to 29.2, P = 0.02). Conclusion: Prehospital treatment and completed registration of patients with anaphylaxis by using the severity classification give advantage to improve the choice of treatment and effectiveness in successful treatment of anaphylaxis.

	Reference
	Alihodžić, H., Ilić, B., Mladina, N., Mršić, D. (2013) Akutni koronarni sindrom poslije uboda stršljena, Kounisov sindrom tip II. Liječ Vjesn, 82-85; 135
	Clark, S., Bock, S., Gaeta, T.J., Brenner, B.E., Cydulka, R.K., Camargo, C.A. (2004) Multicenter study of emergency department visits for food allergies☆. Journal of Allergy and Clinical Immunology, 113(2): 347-352
	Galli, S.J. (2005) Pathogenesis and management of anaphylaxis: Current status and future challenges. Journal of Allergy and Clinical Immunology, 115(3): 571-574
	Gikas, A., Lazaros, G., Kontou-Fili, K. (2005) Acute ST-segment elevation myocardial infarction after amoxycillin-induced anaphylactic shock in a young adult with normal coronary arteries: a case report. BMC Cardiovascular Disorders, 5(1):
	Kane, K.E., Cone, D.C. (2004) Anaphylaxis in the prehospital setting. Journal of Emergency Medicine, 27(4): 371-377
	Lictenstein, L.M., Fauci, A.S. (1988) Curent therapy in allergy, immunology, and rheumatology 3. Toronto, Philadelphia: B.C. Decker Inc, 91-98
	Lieberman, P., Camargo, C.A., Bohlke, K., Jick, H., Miller, R.L., Sheikh, A., Simons, F.E.R. (2006) Epidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Annals of Allergy, Asthma & Immunology, 97(5): 596-602
	Lieberman, P., Nicklas, R.A., Oppenheimer, J., Kemp, S.F., Lang, D.M., Bernstein, D.I., Bernstein, J.A., Burks, A. W., Feldweg, A.M., Fink, J.N., Greenberger, P.A., Golden, D.B.K., James, J.M., Kemp (2010) The diagnosis and management of anaphylaxis practice parameter: 2010 Update. Journal of Allergy and Clinical Immunology, 126(3): 477-480.e42
	Moneret-Vautrin, D.A., Morisset, M., Flabbee, J., Beaudouin, E., Kanny, G. (2005) Epidemiology of life-threatening and lethal anaphylaxis: a review. Allergy, 60(4): 443-451
	Müller, U., Mosbech, H., Blaauw, P., Dreborg, S., Malling, H.J., Przybilla, B., Urbanek, R., Pastorelo, E., Blanca, M., Bousquet, J., Jarisch, R. (1991) Emergency treatment of allergic reactions to Hymenoptera stings. Clin Exp Allergy, 21: 281-288
1	Pumphrey, R.S. (2000) Lessons for management of anaphylaxis from a study of fatal reactions. Clin Exp Allergy, 30, 1144-1150
	Sampson, H.A., Muñoz-Furlong, A. (2006) Campbell RL et all. u: Second symposium on the definition and management of anaphylaxis: summary report - Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy, 117: 391-7
1	Sampson, H.A., Muñoz-Furlong, A., Bock, S. A., Schmitt, C., Bass, R., Chowdhury, B.A., Decker, W.W., Furlong, T.J., Galli, S.J., Golden, D.B. (2005) Symposium on the Definition and Management of Anaphylaxis: Summary report. Journal of Allergy and Clinical Immunology, 115(3): 584-591
	Simons, F.E.R., Ardusso, L.R., Bilò, M., Cardona, V., Ebisawa, M., El-Gamal, Y.M., Lieberman, P., Lockey, R.F., Muraro, A., Roberts, G., Sanchez-Borges, M., Sheikh, A., Shek, L.P., Wallace, D.V., Worm (2014) International consensus on (ICON) anaphylaxis. World Allergy Organization Journal, 7(1): 9
2	Simons, F. E.R., Ardusso, L.R.F., Bilò, M. B., El-Gamal, Y.M., Ledford, D.K., Ring, J., Sanchez-Borges, M., Senna, G.E., Sheikh, A., Thong, B.Y. (2011) World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis. World Allergy Organization Journal, 4(2): 13-36
	Simons, F.E., Ardusso, L.R., Bilo, al M.B. (2012) Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis. Curr Opin Allergy Clin Immunol, 12(4); 389-399
	Simons, F.R. (2004) First-aid treatment of anaphylaxis to food: Focus on epinephrine☆. Journal of Allergy and Clinical Immunology, 113(5): 837-844
5	Soar, J., Deakin, C.D., Nolan, J.P., Abbas, G., Alfonzo, A., Handley, J.A., i dr. (2005) European Resuscitation Council Guidelines for Resuscitation Section 7: Cardiac arrest in special circumstances. Resuscitation, 67(Suppl 1):S135-70
	Soar, J., Pumphrey, R., Cant, A., Clarke, S., Corbett, A., Dawson, P., Ewan, P., Foëx, B., Gabbott, D., Griffiths, M., Hall, J., Harper, N., Jewkes, F., Maconochie, I., Mitchell, S., Nasser, S., Nola (2008) Emergency treatment of anaphylactic reactions-Guidelines for healthcare providers. Resuscitation, 77(2): 157-169
2	Soar, J., Perkins, G.D., Abbas, G., Alfonzo, A., Barelli, A., Bierens, J.J.L.M., Brugger, H., Deakin, C.D., Dunning, J., Georgiou, M., Handley, A.J., Lockey, D.J., Paal, P., Sandroni, C. (2010) European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, p. Resuscitation, 81(10): 1400-1433
	Yocum, M.W., Butterfield, J.H., Klein, J.S., Volcheck, G.W., Schroeder, D.R., Silverstein, M.D. (1999) Epidemiology of anaphylaxis in Olmsted County: A population-based study☆☆☆★★★. Journal of Allergy and Clinical Immunology, 104(2): 452-456

O članku

jezik rada: bosanski
vrsta rada: neklasifikovan
DOI: 10.5937/JRB1604006A
objavljen u SCIndeksu: 25.08.2017.

Povezani članci

Nema povezanih članaka