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Anaphylaxis--recognition and management
Shelley J Kirkbright1, Simon G A Brown
1Royal Perth Hospital, Perth, Western Australia, Australia.
Australian Family Physician
|June 8, 2012
Summary
Anaphylaxis, a severe allergic reaction, requires prompt recognition and management. Early intramuscular adrenaline is key, while steroids and antihistamines are not recommended for initial treatment.
Area of Science:
- Allergy and Immunology
- Emergency Medicine
Background:
- Anaphylaxis is a rapid, multisystem hypersensitivity reaction.
- Diagnosis can be challenging, especially without skin manifestations.
Purpose of the Study:
- To outline the recognition, assessment, and evidence-based management of anaphylaxis.
- Focus on the general practice setting.
Main Methods:
- Review of published guidelines on anaphylaxis management.
- Emphasis on evidence-based treatment protocols.
Main Results:
- Guidelines consistently recommend early intramuscular adrenaline, supine positioning, airway support, and IV fluids.
- Intravenous adrenaline boluses are reserved for cardiac arrest.
- Steroids and antihistamines lack proven efficacy as first-line treatments.
Conclusions:
- Patients require at least 6 hours of observation due to potential protracted or biphasic reactions.
- Follow-up should include cause identification, immunotherapy if applicable, and an action plan with an adrenaline auto-injector.
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