Paeds Cases · allergy-and-immunology
Teaching adrenaline autoinjector and action-plan use — OSCE
Communication and structured-discussion OSCE on teaching the family of a six-year-old — newly diagnosed with peanut anaphylaxis after a reaction in the emergency department — how and when to use the adrenaline autoinjector, what the written ASCIA action plan says, how to keep him safe at school and at home, and how to respond to a second reaction at home, including the mother's anxiety about giving the injection and the father's belief that the first reaction was a one-off.
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Candidate instructions (8-minute station)
You are the paediatric registrar discharging a six-year-old boy from the emergency department after a peanut-triggered anaphylactic reaction. He improved after a single intramuscular adrenaline dose and a period of observation, and he is now well. He has a known peanut allergy and asthma. [3]
Your tasks are: [8]
- Teach the parents how and when to use the adrenaline autoinjector, using the trainer device. [8]
- Explain the written ASCIA action plan and what it asks them to do. [3]
- Advise on peanut avoidance at home and at school, and how the school will be involved. [4]
- Address the mother's fear of giving the injection and the father's belief that the reaction was a one-off. [8]
You are not expected to organise the formal allergy-clinic referral in the station, but you should name it as the next step and explain what it will do. [4]
References3ShowHide
- [3]Simons FE; Ardusso LR; Bilò MB; et al World allergy organization guidelines for the assessment and management of anaphylaxis. World Allergy Organ J, 2011.PMID 23268454
- [4]Muraro A; Worm M; Alviani C; et al EAACI guidelines: Anaphylaxis (2021 update). Allergy, 2022.PMID 34343358
- [8]Sicherer SH; Simons FER; SECTION ON ALLERGY AND IMMUNOLOGY Epinephrine for First-aid Management of Anaphylaxis. Pediatrics, 2017.PMID 28193791