119 Rescue team's awareness of anaphylaxis and asthma exacerbation in Gyeonggi-do province of Korea: Before and after education

Bomi Seo; So-Hee Lee; Min‐Suk Yang; Seon Hwa Lee; Sae-Hoon Kim; Sang-Heon Cho; Yoon-Seok Chang

doi:10.4168/aard.2019.7.4.199

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Seo, Lee, Yang, Lee, Kim, Cho, and Chang: 119 Rescue team's awareness of anaphylaxis and asthma exacerbation in Gyeonggi-do province of Korea: Before and after education

Original Article

Allergy Asthma Respir Dis 2019;7(4):199-205.

Published online: 12 October 2019

DOI: https://doi.org/10.4168/aard.2019.7.4.199

119 Rescue team's awareness of anaphylaxis and asthma exacerbation in Gyeonggi-do province of Korea: Before and after education

Bomi Seo^1,², So-Hee Lee^3,⁴, Min‐Suk Yang^3,⁵, Seon Hwa Lee², Sae-Hoon Kim^1,², Sang-Heon Cho³, Yoon-Seok Chang^1,²

^¹Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam

^²Gyeonggi-do Atopy·Asthma Education Information Center, Seongnam

^³Department of Internal Medicine, Seoul National University College of Medicine, Seoul Korea

^⁴Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul Korea

^⁵Department of Internal Medicine, Seoul Metropolitan Government – Seoul National University Boramae Medical Center, Seoul Korea

Correspondence to: Yoon-Seok Chang https://orcid.org/0000-0003-3157-0447 Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: +82-31-787-7023, Fax: +82-31-787-4052, E-mail: addchang@snu.ac.kr

Received 11 April 2019 Revised 3 May 2019 Accepted 15 May 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Anaphylaxis and asthma exacerbation could be life-threatening medical emergencies. The 119 (911 in the United States) rescue teams are at the forefront of such emergency conditions. Early recognition and proper prehospital management by 119 rescuers are important. We evaluated the awareness of 119 rescuers of anaphylaxis and asthma exacerbation in Korea.

Methods

Between May 17 and June 28 of 2018, a total of 180 rescuers were recruited from Gyeonggi-do province, Korea. The 90-minute educational sessions on anaphylaxis and asthma exacerbation were provided by an allergy specialist, which included some lectures and a hands-on workshop on self-injectable epinephrine autoinjector. A questionnaire survey with the same content was performed before and after education to assess the improvement in awareness. It had 2 domains: anaphylaxis awareness and asthma awareness.

Results

After education, awareness score for anaphylaxis increased from an average of 3.1 (51.7%) to 5.5 (91.7%). Particularly, the effect of education on the use of epinephrine, the most crucial treatment for anaphylaxis, was greatest. The awareness score for asthma after education increased from an average of 21.3 (78.9%) to 25.1 (93%). The effect of education on treatment and management of asthma was greatest.

Conclusion

The 119 rescuers could be the first medical personnel at the forefront of anaphylaxis and asthma exacerbation. Hence, it is important to increase their awareness of anaphylaxis and asthma exacerbation. A simple educational activity can dramatically change the level of awareness.

Keywords: Anaphylaxis, Asthma, Rescue work

References

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Fig. 1.

Distribution of the fire stations and 119 centers of 180 rescuers who participated in the study.

Fig. 2.

Improved awareness on anaphylaxis and asthma exacerbation after education among 119 rescue teams. * P<0.05.

Table 1.

Demographic characteristics (n=180)

Characteristic	Value
Sex
Female	76 (42.2)
Male	104 (57.7)
Age (yr)	32.6±5.3
20–29	59 (32.8)
30–39	100 (55.6)
40–49	20 (11.1)
50–59	1 (0.6)
History of anaphylaxis
No	177 (98.3)
Yes	3 (1.7)
Family history of anaphylaxis
No	173 (96.1)
Yes	7 (3.9)

Values are presented as number (%) or mean±standard deviation.

Table 2.

Number of correct answers for each item in the anaphylaxis questionnaire before and after education

Questionnaire item	Before education, n (%)	After education, n (%)	P-value
1. Have you ever been trained about anaphylaxis	70 (38.8)	161 (89.4)	<0.001
2. Have you ever experienced a patient with anaphylaxis even once?	103 (57.2)	109 (60.5)	0.120
3. Which of following drugs should be used first when a life-threatening allergic reaction occurs?	109 (60.5)	173 (96.1)	<0.001
4. Does your workplace have behavioral guidelines about a severe allergic reaction?	125 (69.4)	139 (77.2)	0.001
5. Have you ever heard of epinephrine self-injector?	139 (77.2)	180 (100)	<0.001
6. Do you know how to use epinephrine self-injector?	90 (50)	178 (98.8)	<0.001
7. What is the case in which epinephrine self-injector should be given? (multiple choices available)	53 (29.4)	133 (73.9)	<0.001
8. What is the route of epinephrine when anaphylaxis occurs?	85 (47.2)	171 (95)	<0.001
9. Where should epinephrine self-injector be kept?	81 (45)	155 (86.1)	<0.001

Table 3.

Number of correct answerers for number 7 item in the anaphylaxis questionnaire before and after education

Questionnaire item	Before education, n (%)	After education, n (%)	P-value
1. Skin rash and itching sense	43 (23.9)	82 (45.6)	<0.001
2. Facial edema with cough and dyspnea	137 (76.1)	178 (98.9)	<0.001
3. Dyspnea and wheezing	117 (65)	109 (60.6)	0.358
4. Vomiting	19 (10.6)	40 (22.2)	<0.001
5. Skin rash and dizziness	54 (30)	134 (74.4)	<0.001
6. I don't know	4 (2.2)	0 (0)	0.125

Table 4.

Average of correct answer scores for each item in the asthma questionnaire before and after education

Questionnaire item	Total score	Before education	After education	P-value
1. Questions about asthma definition and cause	5	4.09	4.51	<0.001
2. Questions about asthma exacerbation factors	7	6.50	6.84	<0.001
3. Questions about symptoms of asthma	2	1.45	1.89	<0.001
4. Questions about treatment and management of asthma	8	5.67	7.09	<0.001
5. Questions about exercise and travel in asthmatics	5	4.56	4.76	0.002

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