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Anaphylaxis: 2020 Practice

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PACULit - Anaphylaxis: 2020 Practice Parameter Update

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Anaphylaxis: 2020 Practice Parameter Update

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Executive Summary

Anaphylaxis is an acute, life-threatening systemic allergic reaction with a wide range of clinical manifestations. The National Institute of Allergy and Infectious Diseases (NIAID) clinical criteria from 2006 continue to provide a helpful framework for approaching patients with acute allergic symptoms.

1. Definition and Diagnosis

This section outlines the criteria for diagnosing anaphylaxis and discusses the challenges in identifying atypical presentations.

Recommendation
Quality of Evidence

Use NIAID clinical criteria for diagnosing anaphylaxis
Moderate

Consider atypical presentations in specific populations
Low

2. Acute Management

This section covers the immediate treatment steps for anaphylaxis, focusing on epinephrine administration and supportive care.

Recommendation
Quality of Evidence

Administer epinephrine as first-line treatment
High

Use intramuscular route for epinephrine administration
Moderate

Monitor patients for at least 4-6 hours after symptom resolution
Low

3. Long-term Management

This section discusses strategies for preventing future anaphylactic episodes and managing patients with a history of anaphylaxis.

Recommendation
Quality of Evidence

Prescribe epinephrine auto-injector for outpatient use
Moderate

Refer patients to an allergist for follow-up
Moderate

Provide patient education on trigger avoidance
Low

4. Special Considerations

This section addresses anaphylaxis management in specific populations or situations, such as pregnancy, infants, and the elderly.

No specific recommendations are provided for this section, but clinicians should be aware of potential modifications to standard management approaches in these populations.

Anaphylaxis Management Workflow

Related Studies

Epidemiology of anaphylaxis: A systematic review
Biphasic anaphylaxis: A review of the literature
Epinephrine auto-injectors: A review of clinical safety and efficacy

Additional Resources

Review Article: Advances in Anaphylaxis Management
Podcast: Recognizing and Treating Anaphylaxis
Video: Proper Use of Epinephrine Auto-Injectors

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