Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2026 01 17 1 11 EN Serkan Filiz Department of Pediatric Allergy and Immunology, Training and Research Hospital, Antalya, Türkiye Güney Külice Department of Pediatric Allergy and Immunology, Training and Research Hospital, Antalya, Türkiye Zeycan Canıtez Oral Department of Pediatric Allergy and Immunology, Training and Research Hospital, Antalya, Türkiye Şennur Keleş Department of Pediatric Allergy and Immunology, Training and Research Hospital, Antalya, Türkiye Dilek Yapar Turkish Ministry of Health, Muratpaşa District Health Directorate, Antalya, Türkiye Osman Keysan Turkish Ministry of Health, Emergy Ambulance Servise Directorate, Antalya, Türkiye Mehmet Gülşen Turkish Ministry of Health, Emergy Ambulance Servise Directorate, Antalya, Türkiye Ahu Sezgin Turkish Ministry of Health, Emergy Ambulance Servise Directorate, Antalya, Türkiye 2025 07 22 2025 10 27 Anaphylaxis is a severe, rapidly progressing, and potentially life-threatening emergency requiring prompt, evidence-based intervention. This study assessed pre-hospital emergency healthcare professionals’ knowledge of anaphylaxis diagnosis, acute management, and treatment protocols in line with current clinical guidelines. A descriptive cross-sectional study was conducted between February and April 2025 among physicians, paramedics, and emergency medical technicians (EMTs) working in Emergency Medical Services (EMS) stations. Data were collected via a 21-item Google Forms survey covering demographics and key knowledge domains based on established pediatric anaphylaxis guidelines. A total of 322 professionals participated: paramedics (n = 214, 66.5%), EMTs (n = 73, 22.7%), and physicians (n = 35, 10.9%). Although most reported prior anaphylaxis training (90.0%) and clinical encounters (87.6%), only 52.2% correctly identified all three diagnostic criteria. Regarding pharmacologic management, 81.7% recognized epinephrine as first-line treatment, with physicians performing best (94.3%) compared to paramedics (81.8%) and EMTs (75.3%). Similarly, 81.1% correctly identified the intramuscular route, with physicians again demonstrating superior knowledge (95.5%). However, major deficiencies were noted in appropriate patient positioning (52.2%) and epinephrine auto-injector use (50.6%), with significant inter-professional differences across both domains. Substantial knowledge gaps exist among pre-hospital emergency providers regarding anaphylaxis diagnosis, patient positioning, and auto-injector administration. Targeted training and standardized protocols are urgently needed to enhance competency and improve patient safety in pre-hospital anaphylaxis management. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4529 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4529/2287