European Resuscitation Council Guidelines for Resuscitation 2005

Soar, Jasmeet; Deakin, Charles D.; Nolan, Jerry P.; Abbas, Gamal; Alfonzo, Annette; Handley, Anthony J.; Lockey, David; Perkins, Gavin D.; Thies, Karl‐Christian

doi:10.1016/j.resuscitation.2005.10.004

Cited by 317 publications

(97 citation statements)

References 257 publications

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“…È imperativo che vengano adottate subito misure terapeutiche atte a prevenire la progressione verso lo shock irreversibile e la morte. Le linee guida attuali raccomandano la somministrazione precoce di adrenalina 15,16 . Deve essere inoltre garantito quanto prima possibile un accesso venoso attraverso cui iniziare un'infusione aggressiva di fluidi 12,17 .…”

Section: Discussioneunclassified

ER triage in patients showing acute hypersensitivity reactions: one year's experience

et al. 2006

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Acute hypersensitivity reactions include different clinical entities, the most threatening of which is anaphylaxis. In the Emergency Department, triage evaluation and decisions can be a determinant of successful treatment. We retrospectively studied 1009 patients who underwent triage in our ED because of acute hypersensitivity over a one year time period. Our aim was to correlate triage priority codes with the clinical manifestations registered at the medical examination, time spent in ED before and after the examination, and admission to hospital or discharge. Emergency codes (red or yellow code) were attributed to 10% of our cases, non-emergency codes (green o white) to 90%. Code grading was changed in 9 patients while awaiting medical evaluation. Severity of symptoms was underestimated in one case, and overestimated in 23. Hospital admission rate was greater among patients with more critical codes. No patient died. In conclusion evaluation, direct observation and re-evaluation are needed for the safe treatment of patients with hypersensitivity reactions in ED, even when initial clinical conditions appear stable

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Section: Discussioneunclassified

ER triage in patients showing acute hypersensitivity reactions: one year's experience

et al. 2006

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“…These treatments may have already started before cardiac arrest occurs and may be useful in the scenario Dr Hogan describes. If cardiac arrest does occur, standard advanced life support guidelines should be followed [7]. These include high quality chest compressions combined with adrenaline and fluid resuscitation.…”

Section: T S Hoganmentioning

confidence: 99%

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Soar¹,

Nolan²

2011

Anaesthesia

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“…Based on Stark and Sullivan's, and Popa and Lerner's original reports (1-8hrs and 3-4hrs, respectively) [4,12], the most common recommendation in treatment guidelines is to observe patients for between four to six hours prior to discharge from the ED [1,23,24]. However, many cases have now been described where the onset of biphasic reactivity was considerably beyond 4 to 6 hrs, sometimes exceptionally so.…”

Section: Clinical Characteristics Of Biphasic Anaphylactic Reactionsmentioning

confidence: 99%

Biphasic Anaphylaxis: A Review of the Incidence, Characteristics and Predictors

Ellis¹

2010

TOALLJ

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While it has been recognized for over a quarter century that anaphylactic reactions have the potential to follow a biphasic course, reports on the incidence of biphasic anaphylaxis are conflicting, and the search for reliable predictive factors of such responses has been challenging. Further adding to the complexity of this clinical entity are the widely variable durations of the asymptomatic window, and the similarly variable reports on second phase severity. This review aims to provide the health care professional with a better understanding of the true incidence, nature, and risk factors for this type of reactivity by consolidating and summarizing the available literature on the topic of biphasic anaphylaxis. As our body of evidence builds, patterns are emerging to suggest that those patients with an initial presentation requiring more than one dose of epinephrine, those who have life-threatening initial presenting features, and those who otherwise take longer to stabilize, are in this higher risk group, and would be more likely to benefit from prolonged in hospital observation. Conversely, patients who respond rapidly to the immediate administration of epinephrine may be at lower risk, but this finding requires confirmation by others. Further prospective evaluations of biphasic anaphylaxis will greatly aid our understanding of this condition.

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European Resuscitation Council Guidelines for Resuscitation 2005

Cited by 317 publications

References 257 publications

ER triage in patients showing acute hypersensitivity reactions: one year's experience

ER triage in patients showing acute hypersensitivity reactions: one year's experience

A reply

Biphasic Anaphylaxis: A Review of the Incidence, Characteristics and Predictors

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