Administration of the adrenaline auto-injector at the nursery/kindergarten/school in Western Japan

In view of the increasing prevalence of food allergies, there has been an associated increase in frequency of situations requiring an emergency response for anaphylaxisat the home, childcare facilities and educational institutions.To clarify the situation of adrenaline auto- injectoradministration in nursery/kindergarten/school, we carried out a questionnaire survey on pediatric physicians in Western Japan.In 2015, self-reported questionnaires were mailed to 421 physicians who are members of the West Japan Research Society Pediatric Clinical Allergy and Shikoku Research Society Pediatric Clinical Allergy.The response rate was 44% (185 physicians) where 160 physicians had a prescription registration for the adrenaline auto- injector. In the past year, 1,330 patients were prescribed the adrenaline auto- injectorwhere 83 patients (6% of the prescribed patients) actually administered the adrenaline auto- injector, of which 14 patients (17% of the administered patients) self-administered the adrenaline auto- injector. " Guardians" at the nursery/kindergarten and elementary school were found to have administered the adrenaline auto- injectorthe most. Among 117 adrenaline auto- injectorprescription-registered physicians, 79% had experienced nonadministration of adrenaline auto- injectorat nursery/kindergarten/school when anaphylaxishas occurred. The most frequent reason cited for not administering the adrenaline auto- injectorwas "hesitation about the timing of administration."If the adrenaline auto- injectorwas administered after the guardianarrived at the nursery/kindergarten/school, it may lead to delayed treatment of anaphylaxisin which symptoms develop in minutes. Education and cooperation among physicians and nursery/kindergarten/school staff will reduce the number of children suffering unfortunate outcomes due to anaphylaxis.