Emergency treatment of anaphylactic reactions--guidelines for healthcare providers.
*The UK incidence of anaphylactic reactions is increasing. *Patients who have an anaphylactic reaction have life-threatening airway and, or breathing and, or circulation problems usually associated with skin or mucosal changes. *Patients having an anaphylactic reaction should be treated using the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. *Anaphylactic reactions are not easy to study with randomised controlled trials. There are, however, systematic reviews of the available evidence and a wealth of clinical experience to help formulate guidelines. *The exact treatment will depend on the patient's location, the equipment and drugs available, and the skills of those treating the anaphylactic reaction. *Early treatment with intramuscular adrenaline is the treatment of choice for patients having an anaphylactic reaction. *Despite previous guidelines, there is still confusion about the indications, dose and route of adrenaline. *Intravenous adrenaline must only be used in certain specialist settings and only by those skilled and experienced in its use. *All those who are suspected of having had an anaphylactic reaction should be referred to a specialist in allergy. *Individuals who are at high risk of an anaphylactic reaction should carry an adrenaline auto-injector and receive training and support in its use. *There is a need for further research about the diagnosis, treatment and prevention of anaphylactic reactions.
Soar
Jasmeet
J
Southmead Hospital, North Bristol NHS Trust, Bristol, UK. Jasmeet.soar@nbt.nhs.uk
Pumphrey
Richard
R
Cant
Andrew
A
Clarke
Sue
S
Corbett
Allison
A
Dawson
Peter
P
Ewan
Pamela
P
Foëx
Bernard
B
Gabbott
David
D
Griffiths
Matt
M
Hall
Judith
J
Harper
Nigel
N
Jewkes
Fiona
F
Maconochie
Ian
I
Mitchell
Sarah
S
Nasser
Shuaib
S
Nolan
Jerry
J
Rylance
George
G
Sheikh
Aziz
A
Unsworth
David Joseph
DJ
Warrell
David
D
D000465:Algorithms; D000707:Anaphylaxis / Q000175:diagnosis* / Q000628:therapy*; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards; D003937:Diagnosis, Differential; D004638:Emergency Treatment / Q000592:standards*; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D010353:Patient Education as Topic; D012017:Referral and Consultation; D013566:Sympathomimetics / Q000008:administration & dosage
D013566:Sympathomimetics; D004837:Epinephrine