CAN-PREPARE

CAN-PREPARE Study

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Canadian Anaphylaxis Network- Predicting Recurrence after Emergency Presentation for Allergic Reaction

Study Summary

Anaphylaxis is the most severe form of allergic reaction that affects multiple systems. Current Canadian treatment guidelines vary widely and recommend that patients who present to the Emergency Department (ED) for anaphylaxis be monitored for a prolonged period (6-24 hours) after initial symptoms have been treated, to increase detection of biphasic anaphylaxis (BA). BA is a second wave of symptoms that occur after initial symptoms have resolved. These monitoring guidelines are based on little evidence and may have a negative impact on patient safety, quality of life, and lead to a waste of resources.

The objective of this study is to conduct a multi-centre observational prospective cohort to develop a clinical prediction rule that identify children with anaphylaxis who are at risk of biphasic anaphylaxis (BA). The study will enroll participants at 7 pediatric EDs that are members of the Pediatric Emergency Research Canada (PERC) network. We will enroll participants <18 years of age presenting to the ED with an allergic reaction that matches the diagnostic criteria of anaphylaxis. Our team will prospectively collect all study data and we will follow participants during their ED visit to ascertain if the participant developed BA in the ED. A standardized follow-up survey will be conducted within 48 hours of enrollment to determine if a biphasic reaction occurred following ED disposition.

Objectives

  1. To create a prognostic clinical prediction model for biphasic anaphylaxis.
  2. To develop a risk-scoring system that informs decisions of children who present to ED with anaphylaxis

Principal Study Investigator: Dr. Waleed Alqurashi and Dr. Amy Plint

Leading Institution: Children’s Hospital of Eastern Ontario

PERT Site Investigator: Dr. Stephen Freedman 

PERT Site Research Coordinator: Jena Shank

Study Team: Dr. Andrew Dixon, Dr. Suzanne Schuh, Dr. Jocelyn Gravel, Dr. Grace Bravo, Dr. Mohamed Eltorki