The Ability of Pediatric Health Care Providers to Visually Identity Peanuts, Tree Nuts and Seeds
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Kara Wada, MD, Princess U. Ogbogu, MD FAAAAI, Sarah Hostetler, MD, Todd L. Hostetler, MD FAAAAI, Bryan L. Martin, DO FAAAAI, Margaret Redmond, MD, Rebecca Scherzer, MD FAAAAI
Rationale: Of the common food allergens, peanuts and tree nuts are the leading cause of fatalities from food-induced anaphylaxis in children. Management hinges on the ability to identify and strictly avoid these foods. Pediatric health care providers are the first line in educating patients on critical avoidance measures.

Methods: A nut display was assembled that contained peanuts, 8 tree nuts and 2 seeds in a total of 19 different forms. Persons attending pediatric grand rounds and other educational sessions at Nationwide Children’s Hospital completed a worksheet to name the items.

Results: One-hundred twenty two subjects completed the study. The mean number of peanuts, tree nuts and seeds identified by all subjects was 13.9 (73%) out of a possible 19. No difference was found based on respondent type (p>0.467):  pediatric faculty 14.2 (74.8%), trainees 13.7 (72.1%), non-clinical staff (16.5, 86.8%) and other clinical staff (14.8, 77.8%). The most commonly identified items were peanuts in the shell (98.4%) and cashews (97.5%). The least identified was almonds in the shell (33.6%).  No difference was seen in the performance of peanut- or tree nut- allergic subjects or those with a first-degree relative with peanut- or tree nut-allergy (13.5, 72.3%) compared with non-allergic subjects (14, 73.6%) (P>0.306).  Eleven participants correctly identified all items (9%).

Conclusions: It is important for pediatric providers to educate peanut- and tree nut-allergic individuals and their caregivers on avoidance measures for peanuts and tree nuts including the ability to properly identify them.  All pediatric healthcare providers may benefit from education in peanut and tree nut identification.