Management of Anaphylactic Patients by Emergency Medical Services

Background: Anaphylaxis is a life-threatening condition, and the response to allergens occurs quickly and is severe. The condition is treated by adrenaline administration via intramuscular injection. However, previous studies have shown low rates of adrenaline use, which affected the patient’s condition. Objective: To analyze adrenaline use in anaphylactic patients by the emergency medical services (EMS). Materials and Methods: This was a retrospective study consisting of patients over 18 years of age assessed and treated through Srinagarind Hospital emergency medical services between January 2013 and December 2018 who fulfilled the diagnostic criteria for anaphylaxis. Results: One hundred nine subjects were examined, 64.2% of whom were male. The mean age of the patients was 26.6+6.8 years. The severity of patients’ signs and symptoms according to the Thai Criteria Based Dispatch for EMS color code was red in 29.4% of cases yellow in 58.7% of cases, and green in 11.9%. Adrenaline was used in 84.4% of cases. The level of operation (with or without a doctor on the EMS team) and discharge disposition at the hospital were factors significantly associated with adrenaline use (p<0.001). Conclusion: Adrenaline use by the EMS was high. The level of operation (with or without a doctor on the EMS team) and discharge disposition at the hospital were factors significantly associated with adrenaline use. Keywords: Pre hospital, EMS, Adrenaline, Allergy, Allergen, Emergency medicine