title: Managing anaphylaxis in the office setting.
abstract: BACKGROUND
  Although the definition of anaphylaxis for clinical use may vary by professional health care organizations and individuals, the definition consistently includes the concepts of a serious, generalized or systemic, allergic or hypersensitivity reaction that can be life-threatening or even fatal.
  
  
  METHODS
  In this review, we presented the important topics in the treatment of anaphylaxis in the office setting. This review will discuss triggers and risk factors, clinical diagnosis, and management of anaphylaxis in the office setting.
  
  
  RESULTS
  Anaphylaxis in the office setting is a medical emergency. It, therefore, is important to prepare for it, to have a posted, written anaphylaxis emergency protocol, and to rehearse the plan regularly. In this review, we presented the important steps in managing anaphylaxis in the office. Treatment of anaphylaxis should start with epinephrine administered intramuscularly at the first sign of anaphylaxis. Oxygen and intravenous fluids may be needed for moderate-to-severe anaphylaxis or anaphylaxis that is quickly developing or if the patient is unresponsive to the first injection of epinephrine. Antihistamine therapy is considered adjunctive to epinephrine, which mainly relieves itching and urticaria. Corticosteroids, with an onset of action of 4-6 hours, have no immediate effect on anaphylaxis.
  
  
  CONCLUSIONS
  To prevent near-fatal and fatal reactions from anaphylaxis, the patient, the family, and the physician must remember to follow the necessary steps when treating anaphylaxis. In anaphylaxis, there is no absolute contraindication for epinephrine.
authors.affiliation: Ear, Nose and Throat (ENT) Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Cingi
authors.forename: Dana
authors.initials: D
authors.lastname: Wallace
authors.forename: Nuray
authors.initials: N
authors.lastname: Bayar Muluk
authors.forename: Motohiro
authors.initials: M
authors.lastname: Ebisawa
authors.forename: Mariana
authors.initials: M
authors.lastname: Castells
authors.forename: Ethem
authors.initials: E
authors.lastname: Şahin
authors.forename: Niyazi
authors.initials: N
authors.lastname: Altıntoprak
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000707:Anaphylaxis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003888:Desensitization, Immunologic / Q000009:adverse effects; D004837:Epinephrine / Q000008:administration & dosage; D005512:Food Hypersensitivity / Q000150:complications; D006801:Humans; D014688:Venoms / Q000009:adverse effects
chemical_list: D000305:Adrenal Cortex Hormones; D014688:Venoms; D004837:Epinephrine