Most school teachers in Bangkok can name food as a common trigger of anaphylaxis, yet almost none can identify the drug that saves lives during an attack. A cross-sectional survey of 280 public and private school teachers, published in BMC Pediatrics, found that while 88.6 percent correctly identified food as a common trigger, only 6.1 percent chose intramuscular epinephrine as the first-line treatment for this life-threatening allergic reaction. The findings expose a critical gap between recognizing that a severe reaction exists and knowing what to do about it.
The study assessed knowledge, perceptions, and factors influencing teachers’ understanding of anaphylaxis in children, using a validated questionnaire based on national anaphylaxis guidelines. Of 310 teachers invited, 280 participated, a response rate of 90.3 percent.
Symptom recognition fared somewhat better than treatment knowledge. Cutaneous symptoms were the most recognized signs, identified by 83.9 percent of respondents. Most teachers, 83.2 percent, could identify anaphylaxis when it presented as combined skin and respiratory symptoms. This suggests that the visible, dramatic features of a severe allergic reaction are more intuitively understood than the pharmacological response required to reverse it.
One factor stood out in the multivariable analysis. After adjustment for potential covariates, having previously heard about or been informed about anaphylaxis remained significantly associated with knowledge of at least one cause of the condition, with an adjusted odds ratio of 4.49 and a 95 percent confidence interval of 1.03 to 19.57, at a p-value of 0.046. Teachers who had encountered information about anaphylaxis somewhere in their professional or personal lives were roughly four and a half times more likely to know at least one cause. The wide confidence interval reflects the modest number of teachers who possessed this knowledge, so the estimate should be read with caution.
The training deficit was stark. A total of 260 teachers, or 92.9 percent, had never received formal training in anaphylaxis management. Nearly as troubling, 40.7 percent were unaware of whether their school even had an anaphylaxis protocol. Even where protocols exist on paper, a substantial share of the adults responsible for children during school hours do not know about them.
Anaphylaxis is a life-threatening allergic reaction requiring immediate treatment with intramuscular epinephrine, also known as adrenaline. In school settings, the timely recognition and intervention of anaphylaxis are critical because the reaction can progress rapidly and the window for effective treatment is short. The authors note that little was previously known about Thai teachers’ preparedness in managing anaphylaxis, making this survey one of the first systematic assessments in this population.
The disconnect between trigger recognition and treatment knowledge has practical consequences. A teacher who knows that food can trigger a severe reaction but does not know that epinephrine is the first-line treatment may delay or omit the intervention that matters most. The survey’s finding that only 17 of 280 teachers chose epinephrine correctly suggests that even motivated staff, absent formal training, default to incomplete or incorrect responses when asked what they would do.
The authors conclude that critical gaps were observed in Thai teachers’ knowledge of anaphylaxis diagnosis and management, especially regarding epinephrine use. They suggest a need for targeted educational interventions and school-based emergency protocols to improve safety for children at risk of anaphylaxis.
Still, the scale of the gaps is difficult to dismiss. With nine in ten teachers untrained and two in five unaware of school protocols, the study provides a concrete baseline for Thai education and health authorities. The association between prior exposure to information about anaphylaxis and better knowledge of its causes offers a hint that even modest informational interventions could shift teacher preparedness, though the survey design cannot confirm that such interventions would work. What the data do establish is that the current state of preparedness in these Bangkok schools falls well short of what the severity of anaphylaxis demands.
Subject of Research: Knowledge and perceptions of school teachers in Bangkok regarding anaphylaxis in school children
Article Title: Knowledge and perceptions of school teachers regarding anaphylaxis in school children
Article References: Suwan, P., & Kanokphitakkul, I. (2026). Knowledge and perceptions of school teachers regarding anaphylaxis in school children. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07942-9
Image Credits: AI Generated
DOI: 10.1186/s12887-026-07942-9
Keywords: anaphylaxis, school teachers, epinephrine, food allergy, Bangkok, Thailand, cross-sectional survey, allergic reaction, emergency protocols, teacher training, BMC Pediatrics, child health
News Source: Harold Sullivan. (November 4, 2026). Thai school teachers know food triggers anaphylaxis but few reach for epinephrine. Scienmag.
