Emergency department anaphylaxis: A review of 142 patients in a single year

Brown, Anthony; McKinnon, David; Chu, Kevin

doi:10.1067/mai.2001.119028

Cited by 312 publications

(289 citation statements)

References 32 publications

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“…It was acknowledged that no criteria will provide 100% sensitivity and specificity, but it was believed that the criteria proposed are likely to capture more than 95% of cases of anaphylaxis. Because the majority of anaphylactic reactions include skin symptoms, [5][6][7][8][9][10] which are noted in more than 80% of cases when carefully assessed, it was judged that at least 80% of anaphylactic reactions should be identified by criterion 1, even when the allergic status of the patient and potential cause of the reaction might be unknown. However, cutaneous symptoms might be absent in up to 20% of anaphylactic reactions in children with food allergy or insect sting allergy.…”

Section: Definition Of Anaphylaxis and Criteria For Diagnosismentioning

confidence: 99%

Second symposium on the definition and management of anaphylaxis: Summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium

Sampson

Muñoz-Furlong²,

Campbell

et al. 2006

Journal of Allergy and Clinical Immunology

1,909

1,114

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Section: Definition Of Anaphylaxis and Criteria For Diagnosismentioning

confidence: 99%

Second symposium on the definition and management of anaphylaxis: Summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium

Sampson

Muñoz-Furlong²,

Campbell

et al. 2006

Journal of Allergy and Clinical Immunology

1,909

1,114

View full text Add to dashboard Cite

“…Although the ratio of patients with anaphylaxis to all patients admitted to the ER was reportedly 0.08%,4 this ratio was likely to have been underestimated due to the difficulty in diagnosing anaphylaxis. In general, foods are the most common cause of anaphylaxis, although there is a wide variation in the ratio of food‐/non‐food‐induced anaphylaxis among studies 4, 6, 7, 8, 9. An important factor affecting the etiology of anaphylaxis is patient age 6, 10, 11, 12.…”

Section: Epidemiologymentioning

confidence: 99%

Drug‐induced anaphylaxis in the emergency room

Takazawa

Oshima

Saito

2017

Acute Medicine & Surgery

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Anaphylaxis is a life‐threatening, systemic allergic reaction that presents unique challenges for emergency care practitioners. Anaphylaxis occurs more frequently than previously believed. Therefore, proper knowledge regarding the epidemiology, mechanisms, symptoms, diagnosis, and treatment of anaphylaxis is essential. In particular, the initial treatment strategy, followed by correct diagnosis, in the emergency room is critical for preventing fatal anaphylaxis, although making a diagnosis is not easy because of the broad and often atypical presentation of anaphylaxis. To this end, the clinical criteria proposed by the National Institute of Allergy and Infectious Diseases and the Food Allergy and Anaphylaxis Network are useful, which, together with a differential diagnosis, could enable a more accurate diagnosis. Additional in vitro tests, such as plasma histamine and tryptase measurements, are also helpful. It should be emphasized that adrenaline is the only drug recommended as first‐line therapy in all published national anaphylaxis guidelines. Most international anaphylaxis guidelines recommend injecting adrenaline by the intramuscular route in the mid‐anterolateral thigh, whereas i.v. adrenaline is an option for patients with severe hypotension or cardiac arrest unresponsive to intramuscular adrenaline and fluid resuscitation. In addition to the route of administration, choosing the appropriate dose of adrenaline is essential, because serious adverse effects can potentially occur after an overdose of adrenaline. Furthermore, to avoid future recurrence of anaphylaxis, providing adrenaline auto‐injectors and making an etiological diagnosis, including confirmation of the offending trigger, are recommended for patients at risk of anaphylaxis before their discharge from the emergency room.

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“…8 Urticaria, with or without angioedema, especially when chronic, is almost never due to IgE-mediated mechanisms.…”

Section: C1-esterase Inhibitormentioning

confidence: 99%