Survey for a suspected perioperative hypersensitivity reaction.
As you likely know, immediate perioperative hypersensitivity (POH) reactions constitute a significant health problem with serious consequences if diagnosis is wrong. However, correct identification of the culprit agent(s) is challenging, given the simultaneous exposure to multiple agents. Moreover, anaesthetized patients can demonstrate normal variations in vital signs which can be misinterpreted as POH and vice versa.
Key information (which can only be provided by the attending anaesthetist who witnessed the reaction) for correct orientation of diagnostic tests, consists of a detailed description of the suspected reaction and the administered drugs as well as measurement of mast cell tryptase ideally drawn 60-90 minutes after onset.
A working group of anaesthetists and allergists created and recently updated the survey for a suspected POH reaction.
Paper version available here:
Upon referral of a patient for allergologic work-up after a suspected POH, we would kindly ask you to fill in a standardized questionnaire that should help making the correct diagnosis and guide safe future anaesthesia.In the future these files could help us to create a database accessible to all anaesthetists.
For referrals to the department of allergy of Antwerp University Hospital (UZA) and AZ Jan Palfijn Ghent, an online survey can be filled in and the data will be sent to an encrypted database, only available for the treating physician.
For referral to other departments of allergy, a pdf file can be printed out and handed over to the allergist by patient.
This pdf can also be transferred to the medical record of the patient.
We thank you for your cooperation
For the working group,
Anaesthetists: L. Sermeus, F. Soetens, R. Van den Eynde
Allergists: D. Ebo, F. Pirson, V. Sabato, R. Schrijvers , M-L. Vander Poorten
In this time of COVID-19 outbreak, the Society for Anesthesia and Resuscitation of Belgium (SARB) would like to register the COVID-19 cases that are managed in the OR’s of Belgian Hospitals, including C-sections.
For that purpose, we would like to ask you to fill in the following questionnaire (one questionnaire for each managed patient, a downloadable version can be found at the following link), with as much information as available, paying attention to strictly respect patient anonymity. In order to link data to a particular patient anonymously, we ask you to attribute a reference number to each patient, using the following format: institution abbreviation followed by order number (e. g. first patient of CHR Citadelle Liege: chrliege1). Your personal data will also remain confidential, and the results will not be publicly available until this publication does not bypass official communication by hospitals. We will, however, need a contact person for each Institution participating into the study. This is the reason why we ask for a contact email address at the beginning of the survey. Should a publication emanate from the analysis of collected data, that contact person will be associated as a co-author of the publication. Today, your Society intends to further support you in the practice of our medical specialty. We will continue to provide you with information and postgraduate leaning opportunities, but we intend to do so in a much more interactive way.
Please note that the protocol of this multi-centric survey has been approved by the ‘Comité d’Ethique Hospitalo-Facultaire, Cliniques Saint Luc’, Brussels. The official approval can be found at the following link, as well as the protocol of the study and certificate of insurance. Personal data protection and ethics require that we obtain consent from the patients to dispose of their data. Due to the current difficult circumstances of the outbreak, and the difficulty of obtaining written consent, oral consent by the patient has been exceptionally authorized by the Ethics Committee. A guide on how to inform the patients about this can be found at the following link, in Dutch and in French. If you want to participate, we would like you to send us back a signed convention of collaboration, and a signed data transfer agreement. Please note that it is necessary to obtain approval of your local Ethics Committee before starting the study. We will be happy to provide you with all supplementary necessary document the Ethics Committee would request for approval.
The collected data will be of great help to draw the picture of OR implications in such an outbreak situation, and will be meaningful only if a maximum of cases are reported. We thank you a lot for your help in achieving this in these troubled times, and remain at your disposal for any questions or concerns regarding this survey.
The SARB Board