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Allergic Reactions: Anaphylaxis

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Updated: Jul 16, 2026

Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber
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Anaphylaxis Clinical Care Pathway: Incorporating Intranasal Epinephrine (Adrenaline).

Timothy E Dribin1, Brad Sobolewski1, Ronna L Campbell2

  • 1Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.

The Journal of Allergy and Clinical Immunology. in Practice
|July 14, 2026
PubMed
Summary

Anaphylaxis management requires prompt allergen removal, patient positioning, and immediate epinephrine (adrenaline) administration via intramuscular or intranasal routes. Continuous monitoring and advanced resuscitation are crucial for severe or persistent cases.

Keywords:
Adrenalineanaphylaxisepinephrineintramuscular epinephrineintranasal epinephrinelife-threatening anaphylaxisprehospitalrefractory anaphylaxis

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Measuring Local Anaphylaxis in Mice
07:49

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Published on: October 14, 2014

Area of Science:

  • Emergency Medicine
  • Clinical Pharmacology
  • Immunology

Background:

  • Anaphylaxis is a severe, potentially life-threatening allergic reaction requiring immediate medical intervention.
  • Current guidelines emphasize prompt recognition and management to improve patient outcomes.

Purpose of the Study:

  • To outline essential steps for healthcare providers in managing anaphylaxis across various clinical settings.
  • To detail the appropriate use of epinephrine and adjunctive resuscitation measures.

Main Methods:

  • The abstract describes a management protocol based on established clinical practice and pharmacokinetic data.
  • Key interventions include allergen removal, patient positioning, and timely epinephrine administration (intramuscular or intranasal).
  • Emphasis is placed on optimizing airway, breathing, and circulation (ABC) resuscitation, including oxygen, ventilation, and fluid resuscitation.

Main Results:

  • Epinephrine (adrenaline) administered intramuscularly (IM) or intranasally (IN) every 5-15 minutes is the cornerstone of anaphylaxis treatment.
  • Both IM and IN routes are considered equally effective.
  • Intravenous epinephrine infusions are recommended for refractory cases after initial IM/IN doses, with aggressive fluid resuscitation for anaphylactic shock.

Conclusions:

  • Effective anaphylaxis management hinges on a systematic approach involving prompt allergen removal, appropriate patient positioning, and timely epinephrine administration.
  • Healthcare providers must be trained in advanced resuscitation techniques, including the judicious use of intravenous epinephrine infusions for severe or persistent reactions.
  • Transfer to advanced care facilities is necessary when advanced resuscitative capabilities are unavailable.