• Ricardo Jose and Gerald J Clesham.
• Department of Medicine, Broomfield Hospital, Chelmsford, UK. rjpj@ananzi.co.za
• Postgrad Med J. 2007 Sep 1; 83 (983): 610611610-1.

BackgroundAnaphylaxis is a life threatening reaction where prompt and appropriate management can save lives. Epinephrine (adrenaline) is the treatment of choice; however, the recommended dose and route of administration of epinephrine used in the management of anaphylaxis is different from that used in the management of cardiac arrest.ObjectiveTo investigate how junior doctors would administer epinephrine in a case of anaphylactic shock in an adult patient.MethodsJunior medical staff in two district general hospitals were assessed with a short questionnaire.Results95 junior hospital doctors were assessed. The majority (94%) would administer epinephrine as the life saving drug of choice, but only 16.8% would administer it as recommended by the UK Resuscitation Council Guidelines.ConclusionJunior doctors may be called to make immediate management decisions in patients with anaphylaxis; however, widespread confusion exists regarding the dose and route of administration of epinephrine. Strategies to improve education and access to appropriate drugs are needed. A labelled "anaphylaxis box" on every resuscitation trolley, containing the dose of epinephrine with clear labelling for intramuscular use, may be one solution.

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