Materiały źródłowe

• #1 Anaphylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482124/

  Anaphylaxis is an acute, life-threatening hypersensitivity disorder defined as a generalized, rapidly evolving, multi-systemic allergic reaction. […] This activity describes the evaluation and treatment of anaphylaxis and explains the role of the interprofessional team in managing patients with this condition. […] Without treatment, anaphylaxis is often fatal due to its rapid progression to respiratory collapse. […] Rapid treatment should be initiated with intramuscular epinephrine if any of these symptoms are present. […] The first hour after the initial symptom onset is the most crucial for treatment. […] Anaphylaxis induces a distributive shock that typically is responsive to fluid resuscitation and the above epinephrine. […] Epinephrine is given through intramuscular injection and at a dose of 0.3 to 0.5 mL of 1:1,000 concentration of epinephrine.

• #1 Anaphylaxis – Allergy & Asthma Network

  https://allergyasthmanetwork.org/anaphylaxis/

  What is the treatment for anaphylaxis? […] Epinephrine is the first line of treatment. Its the ONLY medication proven to stop a life-threatening allergic reaction. Epinephrine needs to be given right away when you notice symptoms. […] Epinephrine is the ONLY drug that will reverse an anaphylactic reaction. It should be given as soon as symptoms appear. […] Any delay in giving epinephrine greatly increases the chance of hospitalization. Fatalities are often associated with either delaying the use of epinephrine or not using it at all. […] Anaphylactic shock is an allergic emergency. It refers to the narrowing of the airways and a drop in blood pressure in response to exposure to an allergen. The treatment is epinephrine first, epinephrine fast, whether shock is present or not. […] After the first dose, monitor symptoms carefully. A second dose of epinephrine can be given if symptoms do not go away or they come back. If a second dose is given, go to the emergency department for additional treatment. […] Remember, initial treatment for anaphylaxis always requires epinephrine.

• #1 Anaphylaxis: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0915/p355.html

  The onset of action of epinephrine is usually three to five minutes, and intramuscular administration into the anterolateral thigh is the preferred route. […] Delayed or lack of epinephrine use continues to be a problem despite current guidelines emphasizing the importance of early administration. […] Antihistamines and corticosteroids are not effective first-line treatments for anaphylaxis. […] Guidelines recommend that antihistamines and corticosteroids be used only as an adjunct to epinephrine. […] Patients should be transported to the hospital for continued therapy and monitoring, especially those with an initial presentation of significant respiratory or circulatory compromise, and patients with refractory anaphylaxis. […] All patients at risk of anaphylaxis should be provided with an action plan instructing them on how to manage an episode of anaphylaxis, including the proper administration of epinephrine. […] Guidelines recommend that all patients diagnosed with an anaphylactic reaction be prescribed an auto-injector.

• #1 Anaphylaxis | Allergy, Asthma & Clinical Immunology | Full Text

  https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0283-4

  Anaphylaxis is an acute, potentially fatal systemic allergic reaction with varied mechanisms and clinical presentations. […] Immediate intramuscular administration of epinephrine into the anterolateral thigh is first-line therapy, even if the diagnosis is uncertain. […] The mainstays of long-term management include specialist assessment, avoidance measures, and the provision of an epinephrine auto-injector and an individualized anaphylaxis action plan. […] The acute treatment of anaphylaxis begins with a rapid assessment of circulation and breathing, followed by the immediate administration of epinephrine. Epinephrine is the drug of choice for anaphylaxis and should be given immediately to any patient with suspected anaphylaxis. […] The recommended dose of epinephrine for anaphylaxis is 0.01 mg/kg (maximum 0.5 mg) administered intramuscularly every 5-15 min as necessary.

• #1 Anaphylaxis Treatment & Management: Approach Considerations, Initial Emergency Department Interventions, Administration of Epinephrine

  https://emedicine.medscape.com/article/135065-treatment

  For the initial assessment, check the airway closely. If needed, establish and maintain an airway and/or provide ventilatory assistance. […] Epinephrine maintains blood pressure, antagonizes the effects of the released mediators, and inhibits further release of mediators. […] Administer intramuscular (IM) epinephrine immediately. […] The FDA approved an intranasal dosage form of epinephrine in August 2024 for treatment of type I allergic reactions, including anaphylaxis. […] The standard treatment of anaphylaxis should also include antihistamines and corticosteroids. However, antihistamines have a much slower onset of action than epinephrine, they exert minimal effect on blood pressure, and they should not be administered alone as treatment. […] Maintaining proper blood pressure is important in the treatment of anaphylactic reactions. Hypotension is often the most difficult manifestation of anaphylaxis to treat.

• #1 Anaphylaxis Treatment & Management: Approach Considerations, Initial Emergency Department Interventions, Administration of Epinephrine

  https://emedicine.medscape.com/article/135065-treatment

  Anaphylaxis is a medical emergency that requires immediate recognition and intervention. Basic equipment and medication should be readily available in the physicians office. […] Prehospital patients with symptoms of severe anaphylaxis should first receive standard interventions. Interventions include high-flow oxygen, cardiac monitoring, and intravenous (IV) access. […] Diagnosis and management guidelines are available from the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology. […] The 2010 Joint Task Force anaphylaxis parameter update, the 2011 World Allergy Organization anaphylaxis guidelines, […] have similar recommendations for immediate treatment in the ED. It should begin with monitoring and treatment, including oxygen, cardiac monitoring, breathing, mental status, skin, and a large-bore IV with isotonic crystalloid solution.

• #1 Anaphylaxis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/8619-anaphylaxis

  If the person can’t breathe, emergency healthcare providers may need to: Place a tube through their nose or mouth into their airway. […] Providers may need to give other treatments for shock, including: IV fluids. […] Benadryl and other antihistamines can treat symptoms of mild, non-anaphylactic allergic reactions like hay fever. It’s not a substitute for epinephrine when treating anaphylaxis. […] If you notice anaphylaxis symptoms, inject yourself with epinephrine right away. Then, call 911 or get to the emergency room. Prompt anaphylaxis treatment can save your life.

• #1 Anaphylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482124/

  When anaphylaxis is diagnosed, co-treatment is often initiated with steroids, antihistamines, inhaled bronchodilators, and vasopressors. […] Corticosteroids are given to reduce the length or biphasic response of anaphylaxis. […] Antihistamines are often routinely used; the most common is H1 blocker administration of diphenhydramine 25 to 50 mg IV/IM. […] Bronchodilators are useful adjuncts in patients with bronchospasm. […] There is no absolute contraindication to treatment with epinephrine in anaphylaxis. […] Patients should always be provided with an epinephrine auto-injector and instructed on how to use it.

• #1 Anaphylaxis

  https://www.nhs.uk/conditions/anaphylaxis/

  Anaphylaxis needs to be treated in hospital immediately. […] Treatments can include: adrenaline given by an injection or drip in your vein, oxygen, fluids given by a drip in your vein. […] You’ll usually stay in hospital for around 2 to 12 hours, but you may need to stay longer. […] Before you leave hospital, you’ll be given 2 adrenaline auto-injectors to keep in case you have another anaphylactic reaction. […] An adrenaline auto-injector is a special device for injecting adrenaline yourself. […] You should be shown how to use your adrenaline auto-injector each time you’re prescribed it. […] You may also be referred to an allergy specialist for tests and advice.

• #1 Patient education: Anaphylaxis treatment and prevention of recurrences (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anaphylaxis-treatment-and-prevention-of-recurrences-beyond-the-basics/print

  If you have a history of anaphylaxis, you should carry epinephrine with you at all times. […] Epinephrine is the only medicine that optimally treats anaphylactic reactions. It is most effective when it is given promptly, before symptoms become severe. […] Neither antihistamines, which mainly relieve hives and itching, nor asthma inhalers (puffers), which mainly relieve coughing and wheezing, can fully treat anaphylaxis effectively. These medications should not be substituted for epinephrine. […] After giving yourself epinephrine, it is important to be evaluated in a hospital emergency department. […] In the emergency department, doctors and nurses can monitor you and if necessary, give oxygen, insert a breathing tube and/or IV. […] Approximately 5 percent of people with anaphylaxis have biphasic (two-phase) anaphylaxis, in which symptoms resolve and then recur without further exposure to the trigger.

• #1 Anaphylaxis Treatment & Management: Approach Considerations, Initial Emergency Department Interventions, Administration of Epinephrine

  https://emedicine.medscape.com/article/135065-treatment

  Short-term desensitization procedures can be used for medication allergy in some circumstances in which no therapeutic alternative exists. […] Anti-IgE (eg, omalizumab) complexes circulating (but not receptor-bound) IgE and keeps it from binding to its receptors. […] The presenting manifestation(s) of anaphylaxis dictate inpatient care. […] Most patients with anaphylaxis may be treated successfully in the ED and then discharged. […] Avoidance is the only form of prevention for most inciting agents. […] Patients at risk for recurrent anaphylaxis should consider wearing a MedicAlert bracelet. […] The patient must be provided a prescription for an epinephrine autoinjector (EpiPen, EpiPen Jr, or Twinject) and instructed in its proper use.

• #1 Anaphylaxis | Causes, Symptoms & Treatment | ACAAI Public Website

  https://acaai.org/allergies/symptoms/anaphylaxis/

  An allergist can also provide a preventative treatment called venom immunotherapy (or venom allergy shots) for insect sting allergy. The treatment works by introducing gradually increasing doses of purified insect venom and has been shown to be 90 to 98 percent effective in preventing future allergic reactions to insect stings. […] If you administer epinephrine and are not better or getting better within minutes, seek emergency care, and if it gets worse, administer the second dose of epinephrine. […] Allergists are specially trained to help you take control of your symptoms, conduct diagnostic tests and review treatment options so you can live the life you want.

• #1 ASCIA Guidelines Acute management of anaphylaxis – Australasian Society of Clinical Immunology and Allergy (ASCIA)

  https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines

  ASCIA guidelines for the acute management of severe allergic reactions (anaphylaxis) are intended for medical practitioners, nurses and other health professionals who provide first responder emergency care. […] Adrenaline (epinephrine) is the first line treatment for anaphylaxis. […] Adrenaline is the first line treatment for anaphylaxis and acts to reduce airway mucosal oedema, induce bronchodilation, induce vasoconstriction and increase strength of cardiac contraction. […] Management of anaphylaxis in pregnant women is the same as for non-pregnant women. Adrenaline should be the first line treatment for anaphylaxis in pregnancy, and prompt administration of adrenaline (1:1,000 IM adrenaline 0.01mg per kg up to 0.5mg per dose) should not be withheld due to a fear of causing reduced placental perfusion.

• #1 Adrenaline & Anaphylaxis | Anaphylaxis UK

  https://www.anaphylaxis.org.uk/fact-sheet/adrenaline/

  Adrenaline is the first line treatment for serious allergic reactions (anaphylaxis). […] Adrenaline acts quickly to reverse the symptoms of anaphylaxis. It opens up the airways by reducing swelling and raises blood pressure. It needs to be given as soon as possible when there are any signs of a serious allergic reaction. Serious symptoms are easier to reverse when theyre treated early. […] Sometimes people use antihistamines first to put off or avoid using adrenaline, but you should use adrenaline first if you think the reaction is anaphylaxis. […] If you have had an allergic reaction, see your GP who can refer you to a specialist allergy clinic if needed. […] Doctors should do a thorough assessment before prescribing adrenaline. This is best done at a specialist allergy clinic or by a GP who has had specialist training in allergy management.

• #1 Anaphylaxis (Anaphylactic Reaction): Symptoms, Causes, Treatment

  https://www.webmd.com/allergies/anaphylaxis

  Epinephrine is the most effective anaphylaxis medication, and you should take it right away. If youve had an anaphylactic reaction before, you should carry at least two doses of epinephrine with you at all times. Epinephrine expires, so make sure your prescription is up to date. If you have an anaphylactic reaction and your epinephrine has expired, take it anyway. […] Epinephrine has long been available as a prefilled pen you use to inject yourself, usually in the thigh. More recently, the FDA approved the epinephrine nasal spray (Neffy) for adults and children who weigh 66 pounds or more. You simply spray it into one nostril. As with the pen, you should carry two doses at all times. When you first start using the spray, your doctor may recommend that you also carry an injector pen. […] You may not need emergency medical care after using epinephrine for anaphylaxis if it stops your symptoms quickly and completely and if you have more epinephrine on hand. But call 911 if: Your reaction is severe Your symptoms don’t get better quickly and completely or nearly completely Your symptoms come back or get worse.

• #2 Anaphylaxis: Emergency treatment – UpToDate

  https://www.uptodate.com/contents/anaphylaxis-emergency-treatment

  Anaphylaxis is a potentially fatal disorder that is underrecognized and undertreated. This may partly be due to failure to appreciate that anaphylaxis is a much broader syndrome than „anaphylactic shock,” and the goal of therapy should be early recognition and treatment with epinephrine to prevent progression to life-threatening respiratory and/or cardiovascular symptoms and signs, including shock. […] This topic will discuss the treatment of anaphylaxis. […] Epinephrine is the first-line treatment for anaphylaxis. […] The clinical manifestations and diagnosis of anaphylaxis, pathophysiology, and unique features of anaphylaxis in specific patient groups are reviewed separately. […] Beneficial effects and adverse effects of epinephrine in the treatment of anaphylaxis.

• #2 Anaphylaxis: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0915/p355.html

  Anaphylaxis is a life-threatening systemic reaction, normally occurring within one to two hours of exposure to an allergen. […] Acute management of anaphylaxis involves removal of the trigger; early administration of intramuscular epinephrine; supportive care for the patient’s airway, breathing, and circulation; and a period of observation for potential biphasic reactions. […] Only after epinephrine administration should adjunct medications be considered; these include histamine H1 and H2 antagonists, corticosteroids, beta2 agonists, and glucagon. […] The mainstay of treatment of acute IgE-mediated or nonimmune anaphylaxis is epinephrine. […] Epinephrine causes an increase in peripheral vascular resistance plus inotropic and chronotropic cardiac effects, leading to an increase in blood pressure.

• #2 ASCIA Guidelines Acute management of anaphylaxis – Australasian Society of Clinical Immunology and Allergy (ASCIA)

  https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines

  ASCIA guidelines for the acute management of severe allergic reactions (anaphylaxis) are intended for medical practitioners, nurses and other health professionals who provide first responder emergency care. […] Adrenaline (epinephrine) is the first line treatment for anaphylaxis. […] Adrenaline is the first line treatment for anaphylaxis and acts to reduce airway mucosal oedema, induce bronchodilation, induce vasoconstriction and increase strength of cardiac contraction. […] Management of anaphylaxis in pregnant women is the same as for non-pregnant women. Adrenaline should be the first line treatment for anaphylaxis in pregnancy, and prompt administration of adrenaline (1:1,000 IM adrenaline 0.01mg per kg up to 0.5mg per dose) should not be withheld due to a fear of causing reduced placental perfusion.

• #2 Anaphylaxis: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1115/p1111.html

  Anaphylaxis is a severe, life-threatening, systemic allergic reaction that is almost always unanticipated and may lead to death by airway obstruction or vascular collapse. […] Administration of intramuscular epinephrine at the onset of anaphylaxis, before respiratory failure or cardiovascular compromise, is essential. Histamine H1 receptor antagonists and corticosteroids may be useful adjuncts. All patients at risk of recurrent anaphylaxis should be educated about the appropriate use of prescription epinephrine autoinjectors. […] Intramuscular epinephrine (1:1,000 dilution dosed at 0.01 mg per kg [maximal dose of 0.3 mg in children and 0.5 mg in adults]), along with appropriate management of airway, breathing, and circulation, is the first and most important therapeutic option in the treatment of anaphylaxis.

• #2 Anaphylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482124/

  Anaphylaxis is an acute, life-threatening hypersensitivity disorder defined as a generalized, rapidly evolving, multi-systemic allergic reaction. […] This activity describes the evaluation and treatment of anaphylaxis and explains the role of the interprofessional team in managing patients with this condition. […] Without treatment, anaphylaxis is often fatal due to its rapid progression to respiratory collapse. […] Rapid treatment should be initiated with intramuscular epinephrine if any of these symptoms are present. […] The first hour after the initial symptom onset is the most crucial for treatment. […] Anaphylaxis induces a distributive shock that typically is responsive to fluid resuscitation and the above epinephrine. […] Epinephrine is given through intramuscular injection and at a dose of 0.3 to 0.5 mL of 1:1,000 concentration of epinephrine.

• #2 Anaphylaxis (Anaphylactic Reaction): Symptoms, Causes, Treatment

  https://www.webmd.com/allergies/anaphylaxis

  Epinephrine is the most effective anaphylaxis medication, and you should take it right away. If youve had an anaphylactic reaction before, you should carry at least two doses of epinephrine with you at all times. Epinephrine expires, so make sure your prescription is up to date. If you have an anaphylactic reaction and your epinephrine has expired, take it anyway. […] Epinephrine has long been available as a prefilled pen you use to inject yourself, usually in the thigh. More recently, the FDA approved the epinephrine nasal spray (Neffy) for adults and children who weigh 66 pounds or more. You simply spray it into one nostril. As with the pen, you should carry two doses at all times. When you first start using the spray, your doctor may recommend that you also carry an injector pen. […] You may not need emergency medical care after using epinephrine for anaphylaxis if it stops your symptoms quickly and completely and if you have more epinephrine on hand. But call 911 if: Your reaction is severe Your symptoms don’t get better quickly and completely or nearly completely Your symptoms come back or get worse.

• #2 First Aid for Anaphylaxis – Australasian Society of Clinical Immunology and Allergy (ASCIA)

  https://www.allergy.org.au/hp/anaphylaxis/first-aid-for-anaphylaxis

  Anaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Anaphylaxis requires immediate treatment with adrenaline (epinephrine). If treatment with adrenaline is delayed, this can result in fatal anaphylaxis. […] ACTIONS FOR ANAPHYLAXIS 1 LAY PERSON FLAT – do NOT allow them to stand or walk If unconscious or pregnant, place in recovery position – on left side if pregnant If breathing is difficult allow them to sit with legs outstretched Hold young children flat, not upright LAY PERSON FLAT do NOT allow them to stand or walk If unconscious or pregnant place in recovery position, on left side if pregnant If breathing is difficult allow them to sit with legs outstretched Hold young children flat not upright Do NOT allow the person to stand or walk

• #2 Anaphylaxis – Immunology; Allergic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/anaphylaxis

  Anaphylaxis is an acute, potentially life-threatening, IgE-mediated allergic reaction that occurs in previously sensitized people when they are reexposed to the sensitizing antigen. […] Treatment is with epinephrine. […] Epinephrine is the cornerstone of treatment for anaphylaxis; it may help relieve all symptoms and signs and should be given immediately. […] Epinephrine can be given subcutaneously or IM (usual dose is 0.3 to 0.5 mL of a 1:1000 [0.1%] solution in adults or 0.01 mL/kg in children, repeated every 5 to 15 minutes). […] Management of cardiac arrest is per standard protocols. […] Patients with hypotension or severe airway obstruction may be given epinephrine IV or intraosseously (IO). […] Antihistamines both H1 blockers (eg, diphenhydramine) and H2 blockers (eg, cimetidine) should be given every 6 hours until symptoms resolve.

• #2 Patient education: Anaphylaxis treatment and prevention of recurrences (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anaphylaxis-treatment-and-prevention-of-recurrences-beyond-the-basics/print

  If you have a history of anaphylaxis, you should carry epinephrine with you at all times. […] Epinephrine is the only medicine that optimally treats anaphylactic reactions. It is most effective when it is given promptly, before symptoms become severe. […] Neither antihistamines, which mainly relieve hives and itching, nor asthma inhalers (puffers), which mainly relieve coughing and wheezing, can fully treat anaphylaxis effectively. These medications should not be substituted for epinephrine. […] After giving yourself epinephrine, it is important to be evaluated in a hospital emergency department. […] In the emergency department, doctors and nurses can monitor you and if necessary, give oxygen, insert a breathing tube and/or IV. […] Approximately 5 percent of people with anaphylaxis have biphasic (two-phase) anaphylaxis, in which symptoms resolve and then recur without further exposure to the trigger.

• #2 Anaphylaxis – Diagnosis & Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/anaphylaxis-diagnosis-treatment/

  Anaphylaxis is a potentially life-threatening emergency that requires immediate diagnosis and treatment. […] Prompt assessment and treatment are critical in anaphylaxis, as respiratory or cardiac arrest and death can occur within minutes. […] The literature has shown that early administration of epinephrine improves patient outcomes and decreases the likelihood of death. […] Administer epinephrine as early as possible. […] Anaphylaxis refractory to IM epinephrine: Start IV epinephrine drip at 1-5 mcg/min and titrate. […] Epinephrine is first-line treatment for anaphylaxis, and there is no known equivalent substitute. […] All patients with anaphylaxis should be observed until symptoms have completely resolved. […] Admission or observation is recommended for patients who do not respond promptly to IM epinephrine, require >1 dose of epinephrine, or received epinephrine only after a significant delay (>60 minutes), as these features may be risk factors for a biphasic response.

• #2 Anaphylaxis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468

  Anaphylaxis requires an injection of epinephrine and a follow-up trip to an emergency room. If you don’t have epinephrine, you need to go to an emergency room immediately. If anaphylaxis isn’t treated right away, it can be fatal. […] If you have an attack and you carry an epinephrine autoinjector, administer it right away. Even if symptoms improve after the injection, you still need to go to an emergency room to make sure symptoms don’t recur, even without more exposure to the allergen. This second reaction is called biphasic anaphylaxis. […] The diagnosis and long-term management of anaphylaxis are complicated, so you’ll probably need to see a doctor who specializes in allergies and immunology. […] Even if you’re careful, at some point you’ll likely be exposed to what you’re allergic to. Fortunately, you can respond quickly and effectively to an allergy emergency by knowing the signs and symptoms of an anaphylactic reaction and having a plan to quickly treat those symptoms.

• #2 Anaphylaxis | Allergy, Asthma & Clinical Immunology | Full Text

  https://aacijournal.biomedcentral.com/articles/10.1186/s13223-018-0283-4

  All patients receiving emergency epinephrine must be transported to hospital immediately (ideally by ambulance) for evaluation and observation. […] The mainstays of long-term management for patients who have experienced anaphylaxis include: specialist assessment, a prescription for an epinephrine auto-injector, patient and caregiver education on avoidance measures, and the provision of an individualized anaphylaxis action plan. […] A prescription for an epinephrine auto-injector should be provided to all patients who have experienced anaphylaxis previously. […] Patients should be educated on certain co-factors that can lead to an increasingly severe anaphylactic reaction. […] A comprehensive, individualized anaphylaxis action plan should be prepared which defines roles and responsibilities and emergency protocols.

• #2 Anaphylaxis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anaphylaxis/diagnosis-treatment/drc-20351474

  During an anaphylactic attack, you might receive cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You might also be given medications, including: […] Epinephrine (adrenaline) to reduce the body’s allergic response […] Intravenous (IV) antihistamines and cortisone to reduce inflammation of the air passages and improve breathing […] A beta-agonist (such as albuterol) to relieve breathing symptoms. […] If insect stings trigger an anaphylactic reaction, a series of allergy shots (immunotherapy) might reduce the body’s allergic response and prevent a severe reaction in the future. […] Carry self-administered epinephrine. During an anaphylactic attack, you can give yourself the drug using an autoinjector. […] Using an autoinjector immediately can keep anaphylaxis from worsening and could save your life.

• #2 ASCIA Guidelines Acute management of anaphylaxis – Australasian Society of Clinical Immunology and Allergy (ASCIA)

  https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines

  Infants with anaphylaxis may retain pallor despite 2-3 doses of adrenaline, and this can resolve without further doses. […] If there is an inadequate response after 2-3 adrenaline doses, or deterioration of the patient, start IV adrenaline infusion, given by staff trained in its use or in liaison with an emergency specialist. […] Caution: IV boluses of adrenaline are NOT recommended without specialised training as they may increase the risk of cardiac arrhythmia. […] Antihistamines have no role in treating or preventing respiratory or cardiovascular symptoms of anaphylaxis. Do not use oral sedating antihistamines as side effects (drowsiness or lethargy) may mimic some signs of anaphylaxis. […] If there is a risk of re-exposure to allergens such as stings or foods, or if the cause of anaphylaxis is unknown (idiopathic) then prescribe and if possible dispense an adrenaline injector before discharge, pending specialist review.

• #2 Adrenaline & Anaphylaxis | Anaphylaxis UK

  https://www.anaphylaxis.org.uk/fact-sheet/adrenaline/

  If you are prescribed adrenaline auto-injectors, keep them with you at all times in case of an emergency. […] Use your first auto-injector straight away if you have any of the ABC symptoms. […] Anaphylaxis (ana-fil-ax-is) is a serious allergic reaction that develops quickly and can sometimes be life threatening, so it needs to be treated quickly. […] Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves difficulty breathing or affects the heart rhythm or blood pressure. […] If your symptoms dont improve or get worse, use your second adrenaline auto-injector 5 minutes after the first. […] Your doctor or allergy specialist should give you a written Allergy Action Plan. This should be tailored for you or your child and will include advice on when to use the adrenaline auto-injectors and what to do in an emergency.

• #2 Anaphylaxis: Recognition and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1115/p1111.html

  The medications most commonly used for treatment of anaphylaxis are epinephrine, histamine H1 receptor antagonists, and corticosteroids. Current practice guidelines unanimously identify the timely administration of epinephrine, at initial diagnosis and ideally before respiratory failure or cardiovascular compromise, as the most important treatment for anaphylaxis. […] The preferred route of administration for epinephrine is intramuscular injection because it provides more reliable and quicker rise to effective plasma levels than the subcutaneous route. […] Adjunct therapies include H1 receptor antagonists and systemic corticosteroids. H1 receptor antagonists are not effective first-line agents for anaphylaxis. […] Corticosteroids may be beneficial in preventing biphasic reactions. […] If a patient with anaphylaxis develops significant respiratory or circulatory symptoms (e.g., hypoxia, respiratory distress, hypotension), transport to a hospital must be arranged for continued therapy and monitoring. […] In most cases of anaphylaxis, symptoms completely abate with intramuscular epinephrine.

• #3 ASCIA Guidelines Acute management of anaphylaxis – Australasian Society of Clinical Immunology and Allergy (ASCIA)

  https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines

  ASCIA guidelines for the acute management of severe allergic reactions (anaphylaxis) are intended for medical practitioners, nurses and other health professionals who provide first responder emergency care. […] Adrenaline (epinephrine) is the first line treatment for anaphylaxis. […] Adrenaline is the first line treatment for anaphylaxis and acts to reduce airway mucosal oedema, induce bronchodilation, induce vasoconstriction and increase strength of cardiac contraction. […] Management of anaphylaxis in pregnant women is the same as for non-pregnant women. Adrenaline should be the first line treatment for anaphylaxis in pregnancy, and prompt administration of adrenaline (1:1,000 IM adrenaline 0.01mg per kg up to 0.5mg per dose) should not be withheld due to a fear of causing reduced placental perfusion.

• #3 Anaphylaxis

  https://www.rch.org.au/clinicalguide/guideline_index/anaphylaxis/

  Anaphylaxis is a severe allergic reaction characterised by an acute onset of cardiovascular (eg hypotension) or respiratory (eg bronchospasm) symptoms. It may be associated with typical skin features (urticarial rash or erythema/flushing and/or angioedema) and/or persistent severe gastrointestinal symptoms […] Treatment of anaphylaxis is intra-muscular adrenaline 10 microgram/kg or 0.01 mL/kg of 1:1000 (maximum 0.5 mL), into lateral thigh which should be repeated after 5 minutes if the child is not improving […] In children with possible anaphylaxis and known asthma, always give adrenaline first, then asthma medicines […] Do not allow children with anaphylaxis to stand or walk […] Anaphylaxis is a clinical diagnosis made in the setting of the acute onset of either criteria […] A detailed history of pre-hospital events is vital to confirm anaphylaxis and its associated trigger(s)

• #3 Understanding Anaphylaxis: Causes, Symptoms, and Treatment

  https://www.everydayhealth.com/anaphylaxis/guide/

  Anaphylaxis requires immediate treatment with an epinephrine injection. This is usually administered before the person gets to a hospital emergency room, which is where they should go as soon as possible. […] An epinephrine injection is considered the only effective treatment for anaphylaxis. […] The primary treatment for anaphylaxis is epinephrine, usually delivered with an auto-injector, which is available by prescription. […] In August 2024, an epinephrine nasal spray (Neffy) was approved in the United States as an alternative to injections for people with a history of severe allergic reactions. […] Epinephrine reverses the symptoms of anaphylaxis in several ways: It causes the blood vessels to constrict, reducing swelling and raising blood pressure. It relaxes the muscles of the airways, making it easier to breathe. It slows or stops the release of some of the chemicals produced in an allergic reaction.

• #3 Anaphylaxis

  https://www.rch.org.au/clinicalguide/guideline_index/anaphylaxis/

  Remove allergen if still present (eg insect stinger, food debris in mouth) […] Lay patient flat. Do not allow the child to stand or walk. Fatality can occur within seconds if the child stands or sits suddenly. Treat the child in the supine position or lying on their side. If a vomiting child is sat upright, monitor for hypotension […] Intramuscular adrenaline 10 microgram/kg or 0.01 mL/kg of 1:1000 (maximum 0.5 mL), into lateral thigh which should be repeated after 5 minutes if the child is not improving […] Do not use subcut adrenaline, as absorption is less reliable than the IM route […] All children with anaphylaxis should be observed for at least 4 hours in a supervised setting with facilities to manage deterioration […] Ensure that asthma control is addressed including diagnosis, action plan, and preventers, as asthma is an independent risk factor for fatal anaphylaxis.

• #3 Anaphylactic Shock: How to Effectively Diagnose and Treat | Today’s Veterinary Practice

  https://todaysveterinarypractice.com/emergency-medicine-critical-care/anaphylactic-shock-effectively-diagnose-treat/

  Rapid patient history and assessment are key in diagnosing and treating anaphylaxis. […] Treatment of anaphylaxis is entirely based on clinical signs but should follow the guidelines for fundamental life support. Treatment should be initiated quickly and take priority over diagnostics because of the likelihood of rapid progression of clinical signs and increasing possibility of death. […] If the patient presents in respiratory distress, it may be necessary to secure an airway. An endotracheal tube may be placed for patients with laryngeal swelling. […] As an α- and β-agonist, epinephrine is essential in the treatment of anaphylaxis. […] Epinephrine works to accelerate heart rate, increase cardiac contractions, decrease mast cell degranulation, and improve oxygenation through bronchodilation.

• #3 Anaphylaxis Medication: Adrenergic Agonists, Antihistamines, H2 Receptor Antagonists, Bronchodilators, Corticosteroids, Positive Inotropic Agents, Vasopressors

  https://emedicine.medscape.com/article/135065-medication

  The primary drug treatments for acute anaphylactic reactions are epinephrine and H1 antihistamines. According to the 2013 World Allergy Association update, 2015 Joint Task Force anaphylaxis update, and 2010 NIAID guidelines, epinephrine is the drug of choice for life-threatening reactions. […] Epinephrine is clearly effective for the most serious effects, and H1-blockers are also effective; do not delay or defer their use in favor of other treatments. […] Corticosteroids are potentially effective in preventing biphasic (ie, recurrent) reactions. Due to their delayed effect, corticosteroids are not first-line treatments. […] H2-blocking antihistamines theoretically are attractive agents for dermal and gastrointestinal (GI) manifestations, but evidence supporting their clinical effectiveness is less than that for H1-blocking agents.

• #3 Management of Anaphylaxis at COVID-19 Vaccination Sites | CDC

  https://www.cdc.gov/vaccines/covid-19/clinical-considerations/managing-anaphylaxis.html

  Epinephrine (1 mg/ml aqueous solution [1:1000 dilution]) is the first-line treatment for anaphylaxis and should be administered immediately, as an intramuscular injection. […] Because of the acute, life-threatening nature of anaphylaxis, there are no contraindications to epinephrine administration. […] Antihistamines (e.g., H1 or H2 antihistamines) and bronchodilators do not treat upper airway obstruction (laryngeal edema) or hypotension and, thus, are not first-line treatments for anaphylaxis. […] Monitoring in a medical facility for several hours is advised, even after complete resolution of symptoms and signs. […] Pregnant women with anaphylaxis should be managed in the same manner as non-pregnant women. […] If anaphylaxis is suspected, administer epinephrine as soon as possible, contact emergency medical services, and transfer patients to a higher level of medical care.

• #3 Patient education: Anaphylaxis treatment and prevention of recurrences (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/anaphylaxis-treatment-and-prevention-of-recurrences-beyond-the-basics/print

  Anyone who has experienced an anaphylactic reaction should be evaluated by a doctor with specific training and experience in the diagnosis and treatment of anaphylaxis who can help you to prevent recurrences. […] It is important to confirm the trigger(s) of the anaphylactic reaction. […] When a trigger has been identified, you should avoid it. […] If you have experienced an anaphylactic reaction due to a food, you should eliminate that food from your diet. […] A course of allergy shots is recommended for anyone who has had an anaphylactic reaction after an insect sting. […] If you have an allergy to a medication, you should learn and record all the different names of that medication and the settings in which you are likely to encounter it. […] People who have experienced an anaphylactic reaction should consider wearing a medical identification bracelet or similar medical identification tag.

• #3 Anaphylaxis: Definition, Symptoms, Causes & Treatment | Ada

  https://ada.com/conditions/anaphylaxis/

  If there is no response to the initial injection, it is recommended to give a further adrenaline dose after five minutes, if the available autoinjector pen contains a second dose. […] People with presumed anaphylaxis are treated in the emergency department. The specifics of treatment depend on how well or unwell overall the person is who experiences an anaphylactic reaction. […] Treatment may include: Adrenaline, also known as epinephrine, usually injected into the thigh muscle and sometimes given multiple times or, in rarer cases, via an intravenous drip. […] An epinephrine autoinjector pen should be carried at all times. They contain a prescribed single or double dose of anaphylaxis medication that is injected into the thigh during an anaphylactic emergency. […] For some people, it is possible to undergo allergen immunotherapy, also known as desensitization or hyposensitization therapy, which means the body is very slowly over months or years exposed to the trigger responsible for their allergy. This causes the immune system to get used to the trigger gradually, helping to reduce the severity of the allergic reaction in the future.

• #3 Adrenaline & Anaphylaxis | Anaphylaxis UK

  https://www.anaphylaxis.org.uk/fact-sheet/adrenaline/

  Schools in the UK are able to buy spare adrenaline auto-injectors without a prescription. These are to use in emergencies to treat children who are at risk of anaphylaxis but whose own device is not available. […] You should be prescribed two adrenaline auto-injectors to carry at all times. You may need to use a second one if symptoms dont improve or get worse 5 minutes after the first injection. […] Some people worry that adrenaline may be harmful, but evidence shows auto-injectors are relatively safe as long as they are used correctly. […] If youre not sure if your reaction is serious, play it safe and use adrenaline. Serious symptoms are easier to reverse when theyre treated early. […] Make sure you know how to use your adrenaline auto-injectors. The doctor who prescribed them should show you how to use them or arrange training for you and your family.

• #3 Anaphylaxis: Highlights from the practice parameter update | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/2/106

  Epinephrine is the first-line therapy for anaphylaxis, and its administration should not be delayed, as delays are associated with higher rates of morbidity and mortality. […] Epinephrine should be administered at the onset of anaphylaxis, intramuscularly in the mid-outer thigh at a dose of 0.01 mg/kg of a 1:1000 (1-mg/mL) solution, up to a maximum dose of 0.5 mg in adults and 0.3 mg in children. […] After treatment of anaphylaxis, monitor the patient until signs and symptoms have fully resolved. Extended observation is suggested for patients with severe anaphylaxis and those who require more than 1 dose of epinephrine. This is indicated to monitor for a potential biphasic reaction. […] Any patient who has experienced anaphylaxis should be evaluated by an allergy and immunology specialist to determine the causative agent, if any. It is not possible to predict the severity of any future event based on the severity of past events. Therefore, consider prescribing an epinephrine autoinjector to patients who have experienced anaphylaxis. Instruct patients on the use of the device, and educate them on the risk of anaphylaxis recurrence and trigger avoidance.

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