Management of Anaphylaxis

• Flowchart Anaphylaxis algorithm

• Flowchart Refractory Anaphylaxis algorithm

Algorithms reproduced with the kind permission of the Resuscitation Council (UK).

Other information

Anaphylaxis can be precipitated by a broad range of triggers which can include medicines, food, radio-opaque dyes and venom. On admission, known allergies must be clearly documented on the Hospital Electronic Prescribing and Medicines Administration (HEPMA) system/prescription chart and in the medical notes. Any new allergies identified must be documented and communicated to the patient and the patient’s GP. If a drug is the trigger then also complete a ‘Yellow card’ adverse drug reaction form. Forms can be found in the BNF or at www.yccscotland.scot.nhs.uk/.

Follow the National Institute for Health and Care Excellence (NICE) guidance "Anaphylaxis: assessment and referral after emergency treatment" available here, specifically:

• All patients should be referred to a specialist clinic for allergy assessment.
• Offer patients (or, if appropriate, their parent and/or carer) an appropriate adrenaline auto-injector (request a supply of two auto-injectors at discharge) as an interim measure before the specialist allergy review (unless the reaction was drug-induced).
• Patients prescribed adrenaline auto-injectors (and/or their parents/carers) must receive training in their use, and have an emergency management or action plan.
• Anaphylaxis reactions should be reported to the UK Anaphylaxis Registry www.anaphylaxie.net (to register, email anaphylaxis.registry@imperial.ac.uk) and guidance should be followed for the reporting and debriefing of adverse events. [Resuscitation Council (UK) guidance available here].