No abstract

In CsA-treated RTRs, antioxidant supplementation decreased blood CsA, which may affect adequacy of immunosuppression.

IntroductionAnaphylaxis is widely accepted to be an increasing problem worldwide. This inquiry into pre-hospital incidence and patient demographics is useful to determine status of anaphylaxis in Tasmania. Our main goal was to determine the incidence of pre-hospital anaphylaxis in Tasmania and identify trends in characteristics of affected patients.MethodsRaw data was searched and extracted from Ambulance Tasmania electronic recording system and case records for the period 1st January 2007 to 31st December 2011. This involved data mining 279,482 cases with the search parameters of anaphylaxis and allergy/ allergic reaction.ResultsThere were 1,570 patients were classified as having allergic reaction (including the most severe form of anaphylaxis). 379 (24.1%) of the atopic group were given a final primary diagnosis of anaphylaxis. The adult cases distribution was female at 219 (57.8%) versus males at 160 cases (42.2%). Interestingly 21.1% of the total anaphylaxis cases were paediatric (n=80) with a greater percentage of male (n=46) to female (n=34) paediatric patients. Aetiology was identified in 85.5% of the cases accordingly: envenomation (insects) 141 (37.2%), food 118 (31.1%), medication 58 (15.3%), known other 4 (1.1%), exercise 3 ( ConclusionThese findings suggest that almost a quarter of all calls for allergy or allergic reaction are of a severe potentially life-threatening nature, with the most common aetiology envenomation from insects (jack jumper bites).

Background: Anaphylaxis is a significant health concern within the community.  The early administration of adrenaline to patients experiencing anaphylaxis has long been recognised as the cornerstone of treatment.  Health-care providers, including general practitioners, nurses and paramedics, are well equipped to manage anaphylaxis through the administration of adrenaline.  Patients themselves also often have adrenaline auto injectors, allowing early self-management.  The objective of this study was to determine the rates of adrenaline administration and identify the administering persons for all anaphylaxis patients presenting to ambulance services in Tasmania from January 1st 2008 until December 31st 2011 by using a retrospective chart review.  Methods: Ambulance Tasmania electronic case reports (n=226 421) from the period January 1st 2008 to December 31st 2011 were searched for all cases fitting the parameters of anaphylaxis, allergy or allergic reaction.  Of these cases, 373 were given a final paramedic diagnosis of anaphylaxis and constituted the primary data for this report. Results: Ambulance Tasmania attended 373 patients during the study period that were given a final primary diagnosis of anaphylaxis - of these 59 (15.8%) were excluded, leaving 314 electronic records for analysis.  Of the cases identified, 71.7% (n=225) were administered adrenaline according to paramedic records.  Adrenaline was administered by a range of health professionals, including general practitioners (n=27), paramedics (n=159), ambulance volunteers (n=4), nurses (n=1) and other health professionals (n=3).  Adrenaline was self-administered by 12.4% (n=28) of patients, with an additional 11.6% (n=26) receiving adrenaline from a non-health care worker (layperson).  In 10.2% of cases (n=23) adrenaline was administered by more than one provider.  Administration of adrenaline prior to paramedic arrival was evident in fewer than 10% of cases treated with adrenaline (n=22). Conclusion: The early administration of adrenaline in anaphylaxis is often vital for patient recovery. This study shows that adrenaline is administered by a number of different providers, with early administration accounting for only 9.8% of presentations treated with adrenaline. These findings raise the question, is adrenaline being administered early enough and often enough to improve health outcomes?

No abstract