[Management of anaphylaxis : part 2: treatment and emergency equipment]

Anaphylaxis is an extreme form of allergic reaction that can be life-threatening. Early treatment of circulatory and pulmonary disturbances is decisive for prognosis. Initial management of anaphylaxis comprises, where possible, interrupting allergen exposure; ensuring a stable airway; summoning emergency services; placing the patient in a safe position, obtaining venous access and monitoring vital signs. Adrenaline, histamine-antagonists and glucocorticoids have proven effective, as has administration of oxygen and volume substitutes. Many anaphylaxis patients are unable to successfully avoid the elicitor and the feasibility of self-treatment is limited if the patient is inadequately informed. An educational program for adult patients and parents of children with a high risk of anaphylaxis has been developed by the German Working Group for Anaphylaxis Training and Education (AGATE). This program aims to help prevent anaphylactic attacks, foster optimal first-line treatment and offer psychological and social support for anaphylaxis patients. Preliminary results confirm the efficacy of the AGATE approach. This article presents an overview of the stage-wise management of anaphylaxis in accordance with the S2 position paper of the German allergological societies and international guidelines.