Allergy alerts - The incidence of parentally reported allergies in children presenting for general anesthesia.

David Sommerfield, Aine Sommerfield, Alina Schilling, Lliana Slevin, Michaela Lucas, Britta S von Ungern-Sternberg

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and aim: Pediatric patients increasingly report allergies, including allergies to food and medications. We sought to determine the incidence and, nature of parent-reported allergies in children presenting for surgery and its significance for anesthetists. Methods: We prospectively collected data on admissions through our surgical admission unit over a 2-month period at a pediatric tertiary care teaching hospital. Data collected included patient demographics, history of atopy, with more comprehensive information collected if an allergy was reported. A clinical immunologist and an anesthetist reviewed the documentation of all patients reporting an allergy. Results: We reviewed 1001 pediatric patients, 158 (15.8%) patients with parent-reported allergies; to medications/drugs (n = 73), food (n = 66), environmental allergens (dust/grasses, n = 35), tapes/dressings (n = 27), latex (n = 4), and venom (eg, bee, wasp, n = 9). Forty-one patients reported antibiotic allergies, with Beta-lactam antibiotics being the most common, with the majority presenting with rash alone (57%). Ten patients reported allergies to nonsteroidal anti-inflammatory drugs and eight to opioids. Twenty-four patients reported egg and/or peanut allergy. Only 3/1001 (0.3%) patients were deemed to have evidence of likely IgE-mediated drug allergy. Of the reported allergies, only 60 (38.2%) had been investigated prior, most likely to be followed up were food (53%) and environmental allergies (44.4%). Only 4/73 (5.5%) reported medication allergies had further follow-up. Just four patients (0.4% of the entire cohort) had drug sensitivities/allergies that were likely to majorly alter anesthesia practice. Conclusion: Only the minority of parent-reported allergies in pediatric surgical patients were specialist confirmed and likely to be clinically relevant. Self-reported food allergy is commonly specialist verified whereas reactions to medications were generally not. Over-reporting of allergies is increasingly common and limits clinician choice of medications. Better education of patients and their families and more timely verification or dismissal of parent-reported reactions is urgently needed. © 2018 John Wiley & Sons Ltd
Original languageEnglish
Pages (from-to)153-160
Number of pages8
JournalPediatric Anesthesia
Volume29
Issue number2
Early online date19 Dec 2018
DOIs
Publication statusPublished - Feb 2019

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General Anesthesia
Hypersensitivity
Incidence
Pediatrics
Drug Hypersensitivity
Food Hypersensitivity
Egg Hypersensitivity
Peanut Hypersensitivity
Bee Venoms
Anti-Bacterial Agents
Food
Wasps
Latex
beta-Lactams
Patient Education
Tertiary Healthcare
Bandages
Poaceae
Exanthema
Dust

Cite this

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title = "Allergy alerts - The incidence of parentally reported allergies in children presenting for general anesthesia.",
abstract = "Background and aim: Pediatric patients increasingly report allergies, including allergies to food and medications. We sought to determine the incidence and, nature of parent-reported allergies in children presenting for surgery and its significance for anesthetists. Methods: We prospectively collected data on admissions through our surgical admission unit over a 2-month period at a pediatric tertiary care teaching hospital. Data collected included patient demographics, history of atopy, with more comprehensive information collected if an allergy was reported. A clinical immunologist and an anesthetist reviewed the documentation of all patients reporting an allergy. Results: We reviewed 1001 pediatric patients, 158 (15.8{\%}) patients with parent-reported allergies; to medications/drugs (n = 73), food (n = 66), environmental allergens (dust/grasses, n = 35), tapes/dressings (n = 27), latex (n = 4), and venom (eg, bee, wasp, n = 9). Forty-one patients reported antibiotic allergies, with Beta-lactam antibiotics being the most common, with the majority presenting with rash alone (57{\%}). Ten patients reported allergies to nonsteroidal anti-inflammatory drugs and eight to opioids. Twenty-four patients reported egg and/or peanut allergy. Only 3/1001 (0.3{\%}) patients were deemed to have evidence of likely IgE-mediated drug allergy. Of the reported allergies, only 60 (38.2{\%}) had been investigated prior, most likely to be followed up were food (53{\%}) and environmental allergies (44.4{\%}). Only 4/73 (5.5{\%}) reported medication allergies had further follow-up. Just four patients (0.4{\%} of the entire cohort) had drug sensitivities/allergies that were likely to majorly alter anesthesia practice. Conclusion: Only the minority of parent-reported allergies in pediatric surgical patients were specialist confirmed and likely to be clinically relevant. Self-reported food allergy is commonly specialist verified whereas reactions to medications were generally not. Over-reporting of allergies is increasingly common and limits clinician choice of medications. Better education of patients and their families and more timely verification or dismissal of parent-reported reactions is urgently needed. {\circledC} 2018 John Wiley & Sons Ltd",
author = "David Sommerfield and Aine Sommerfield and Alina Schilling and Lliana Slevin and Michaela Lucas and {von Ungern-Sternberg}, {Britta S}",
year = "2019",
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Allergy alerts - The incidence of parentally reported allergies in children presenting for general anesthesia. / Sommerfield, David; Sommerfield, Aine; Schilling, Alina; Slevin, Lliana; Lucas, Michaela; von Ungern-Sternberg, Britta S.

In: Pediatric Anesthesia, Vol. 29, No. 2, 02.2019, p. 153-160.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Allergy alerts - The incidence of parentally reported allergies in children presenting for general anesthesia.

AU - Sommerfield, David

AU - Sommerfield, Aine

AU - Schilling, Alina

AU - Slevin, Lliana

AU - Lucas, Michaela

AU - von Ungern-Sternberg, Britta S

PY - 2019/2

Y1 - 2019/2

N2 - Background and aim: Pediatric patients increasingly report allergies, including allergies to food and medications. We sought to determine the incidence and, nature of parent-reported allergies in children presenting for surgery and its significance for anesthetists. Methods: We prospectively collected data on admissions through our surgical admission unit over a 2-month period at a pediatric tertiary care teaching hospital. Data collected included patient demographics, history of atopy, with more comprehensive information collected if an allergy was reported. A clinical immunologist and an anesthetist reviewed the documentation of all patients reporting an allergy. Results: We reviewed 1001 pediatric patients, 158 (15.8%) patients with parent-reported allergies; to medications/drugs (n = 73), food (n = 66), environmental allergens (dust/grasses, n = 35), tapes/dressings (n = 27), latex (n = 4), and venom (eg, bee, wasp, n = 9). Forty-one patients reported antibiotic allergies, with Beta-lactam antibiotics being the most common, with the majority presenting with rash alone (57%). Ten patients reported allergies to nonsteroidal anti-inflammatory drugs and eight to opioids. Twenty-four patients reported egg and/or peanut allergy. Only 3/1001 (0.3%) patients were deemed to have evidence of likely IgE-mediated drug allergy. Of the reported allergies, only 60 (38.2%) had been investigated prior, most likely to be followed up were food (53%) and environmental allergies (44.4%). Only 4/73 (5.5%) reported medication allergies had further follow-up. Just four patients (0.4% of the entire cohort) had drug sensitivities/allergies that were likely to majorly alter anesthesia practice. Conclusion: Only the minority of parent-reported allergies in pediatric surgical patients were specialist confirmed and likely to be clinically relevant. Self-reported food allergy is commonly specialist verified whereas reactions to medications were generally not. Over-reporting of allergies is increasingly common and limits clinician choice of medications. Better education of patients and their families and more timely verification or dismissal of parent-reported reactions is urgently needed. © 2018 John Wiley & Sons Ltd

AB - Background and aim: Pediatric patients increasingly report allergies, including allergies to food and medications. We sought to determine the incidence and, nature of parent-reported allergies in children presenting for surgery and its significance for anesthetists. Methods: We prospectively collected data on admissions through our surgical admission unit over a 2-month period at a pediatric tertiary care teaching hospital. Data collected included patient demographics, history of atopy, with more comprehensive information collected if an allergy was reported. A clinical immunologist and an anesthetist reviewed the documentation of all patients reporting an allergy. Results: We reviewed 1001 pediatric patients, 158 (15.8%) patients with parent-reported allergies; to medications/drugs (n = 73), food (n = 66), environmental allergens (dust/grasses, n = 35), tapes/dressings (n = 27), latex (n = 4), and venom (eg, bee, wasp, n = 9). Forty-one patients reported antibiotic allergies, with Beta-lactam antibiotics being the most common, with the majority presenting with rash alone (57%). Ten patients reported allergies to nonsteroidal anti-inflammatory drugs and eight to opioids. Twenty-four patients reported egg and/or peanut allergy. Only 3/1001 (0.3%) patients were deemed to have evidence of likely IgE-mediated drug allergy. Of the reported allergies, only 60 (38.2%) had been investigated prior, most likely to be followed up were food (53%) and environmental allergies (44.4%). Only 4/73 (5.5%) reported medication allergies had further follow-up. Just four patients (0.4% of the entire cohort) had drug sensitivities/allergies that were likely to majorly alter anesthesia practice. Conclusion: Only the minority of parent-reported allergies in pediatric surgical patients were specialist confirmed and likely to be clinically relevant. Self-reported food allergy is commonly specialist verified whereas reactions to medications were generally not. Over-reporting of allergies is increasingly common and limits clinician choice of medications. Better education of patients and their families and more timely verification or dismissal of parent-reported reactions is urgently needed. © 2018 John Wiley & Sons Ltd

U2 - 10.1111/pan.13541

DO - 10.1111/pan.13541

M3 - Article

VL - 29

SP - 153

EP - 160

JO - Pediatric Anesthesia

JF - Pediatric Anesthesia

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ER -