Emergency Monitoring Following A Diagnosis of Anaphylaxis

In this review we explore expanding options for monitoring following anaphylaxis in the home or community setting. We review recent literature to help identify who might benefit from watchful waiting at home versus immediate emergency medical service (EMS) activation following anaphylaxis.

Recent studies confirm that most patients respond promptly, completely, with a durable response to a single dose of epinephrine for anaphylaxis. In monophasic anaphylaxis, reflexive emergency monitoring has been found to have minimal benefit. In recent years, studies show increasing emergency department utilization for anaphylaxis, though the risk of fatal anaphylaxis remains exceedingly low. Identifying patients at risk for severe anaphylaxis is imprecise, though several risk factors have been associated with higher chances of severe reactions. Reflexive emergency monitoring following anaphylaxis is not necessary in all cases of anaphylaxis. Carefully selected patients may benefit from watchful waiting at home. Engaging in shared decision making is critical in this new era of personalized allergy action plans. Future studies are necessary to refine our understanding of the full risks and benefits of home monitoring following anaphylaxis.