Anaphylaxis

Welcome back to the podcast!

In this episode of Roadside to Resus we’re going to take a look Anaphylaxis, which has been highlighted on a national level of concern as NICE state ‘many people do not receive optimal management following their acute anaphylactic reaction’.

Much of the problem lies within a lack of understanding of what actually constitutes an anaphylactic reaction and the knock on effect this has to the treatment provided.

In this episode we’ll explore the definition of anaphylaxis and the significant differences that can be seen in the presentation. We have a a think about the pathophysiology and reasons behind the variance in presentations and how this affects the importance of treatments available and their relative importance.

Anaphylaxis is known to have a a number of patients who have a biphasic reaction, it predicates the need to convey patients to hospital and a period of observation; however the frequency and severity of these biphasic reactions can help to inform this further and for that reason we take a look at the literature on it.

We’ve covered angioedema before in a separate episode, but we briefly cover the similarities and differences and how this affects management, but if you want to hear more about this have a listen to the full angioedema episode here.

Lastly we cover the follow up and management that these patients require.

We’d love to hear any comments or feedback you have and make sure to take a look at the references and resources below.

Enjoy!

SimonRob & James

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References

Life in the Fast Lane; Anaphylaxis

RCEMLearning; Anaphylaxis

TheResusRoom; Angioedema

Immediate Hypersensitivity Reactions. Angel A. Stats Pearls. 2020
The pathophysiology of anaphylaxis. Laurent L. J Allergy Clin Immunol. 2018
Fatal asthma or anaphylaxis? J Rainbow. Emerg Med J. 2002
Anaphylaxis. Kim H. Allergy, Asthma & Clinical Immunology. 2011

Anaphylaxis. Fischer. Allergy Asthma Clin Immunol. 2018

Glucocorticoids for the treatment of anaphylaxis. Cochrane Database of Systematic Reviews. Choo K. 2012

Incidence of clinically important biphasic reactions in emergency department patients with allergic reactions or anaphylaxis. Grunau B, Annals of Emerg Med. 2013 

Emergency department corticosteroid use for allergy or anaphylaxis is not associated with decreased relapses. 

Immediate Hypersensitivity Reactions. Angel A. Stats Pearls. 2020
The pathophysiology of anaphylaxis. Laurent L. J Allergy Clin Immunol. 2018.
Fatal asthma or anaphylaxis? J Rainbow. Emerg Med J. 2002
Anaphylaxis. Kim H. Allergy, Asthma & Clinical Immunology. 2011

Anaphylaxis. Fischer. Allergy Asthma Clin Immunol. 2018

Glucocorticoids for the treatment of anaphylaxis. Cochrane Database of Systematic Reviews. Choo K. 2012

Incidence of clinically important biphasic reactions in emergency department patients with allergic reactions or anaphylaxis. Grunau B, Annals of Emerg Med. 2013 

Emergency department corticosteroid use for allergy or anaphylaxis is not associated with decreased relapses. Grunau B. Annals of Emerg Med. 2015

H2-antihistamines for the treatment of anaphylaxis with and without shock: a systematic review. Nurmatov, U. Annals of Allergy, Asthma and Immunology. 2014

Lessons for the management of anaphylaxis from a study of fatal reactions. Clinical and Experimental Allergy. Pumphrey, R . 2000

Fatal anaphylaxis in the UK, 1992-2001. Novartis Foundation Symposium. Pumphrey. 2004

H1-antihistamines for the treatment of anaphylaxis with and without shock. Cochrane Database of Systematic Reviews. Sheikh, S. 2007

Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock. Cochrane Database of Systematic Reviews. Sheikh. 2008

Time to revisit the definition and clinical criteria for anaphylaxis? Paul J. Turner. World Allergy Organ J. 2019

H2-antihistamines for the treatment of anaphylaxis with and without shock: a systematic review. Nurmatov, U. Annals of Allergy, Asthma and Immunology. 2014

Lessons for the management of anaphylaxis from a study of fatal reactions. Clinical and Experimental Allergy. Pumphrey, R . 2000

Fatal anaphylaxis in the UK, 1992-2001. Novartis Foundation Symposium. Pumphrey. 2004

H1-antihistamines for the treatment of anaphylaxis with and without shock. Cochrane Database of Systematic Reviews. Sheikh, S. 2007

Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock. Cochrane Database of Systematic Reviews. Sheikh. 2008

Time to revisit the definition and clinical criteria for anaphylaxis? Paul J. Turner. World Allergy Organ J. 2019

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