Recognition, Treatment, and Prevention of Anaphylaxis - 03/04/15

Doi : 10.1016/j.iac.2015.01.006

Lindsey E. Moore, DO ^a, Ann M. Kemp, RPh, MD ^b, Stephen F. Kemp, MD ^a,^⁎
^a Division of Clinical Immunology and Allergy, Department of Medicine, The University of Mississippi Medical Center, Jackson, MS 39216, USA
^b Department of Family Medicine, The University of Mississippi Medical Center, Jackson, MS 39216, USA

^∗Corresponding author. Division of Clinical Immunology and Allergy, Department of Medicine, The University of Mississippi Medical Center, 878 Lakeland Drive, Building LB, Jackson, MS 39216.

Résumé

Anaphylaxis is an acute and potentially lethal multisystem allergic reaction that occurs in a variety of clinical scenarios and is almost unavoidable. Immunologic reactions to medications, foods, and insect stings cause most episodes, but virtually any substance capable of inducing systemic degranulation of mast cells and basophils can produce anaphylaxis. All health care professionals must be able to recognize anaphylaxis promptly, be prepared to treat it appropriately, and be able to provide preventive recommendations. Similarly, at-risk individuals must be prepared to self-treat anaphylaxis promptly if prevention fails.

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Keywords : Anaphylaxis, Epinephrine, Management, Observation, Prevention

Plan

Key points

Introduction

Clinical recognition of anaphylaxis

Management of anaphylaxis

Epinephrine

Therapeutic options after intramuscular epinephrine

Oxygen and Beta2-agonists

Fluid Resuscitation for Persistent Hypotension

Intravenous Epinephrine

Second-line therapeutic agents for anaphylaxis

Observation after anaphylaxis

Prevention of anaphylaxis

Summary

Conflicts of interest: Dr S.F. Kemp has served as an anaphylaxis advisor for Sanofi US Services (Bridgewater, NJ). The other authors have no potential conflicts of interest to declare.