Management of anaphylaxis

Abstract

Anaphylaxis requires immediate medical treatment. At the present time, the mainstays of therapy include educating patients and their caregivers to strictly avoid allergens, recognize early symptoms, and to self-administer injectable epinephrine. In a hospital setting the initial management of anaphylaxis includes a focused examination, procurement of a stable airway and intravenous access, and administration of epinephrine with antihistamines and steroids often used as adjuncts. Interventions include high-flow oxygen, cardiac monitoring, and intravenous access. Certain drugs, such as beta-blockers and angiotensin-converting enzyme (ACE) inhibitors, may hinder the successful treatment of an anaphylactic reaction and glucagon infusion can be considered inpatients on the former. A period of in hospital observation between 2 and 24 hours is recommended following stabilization due to concerns of biphasic anaphylaxis. Anaphylaxis is a clinical diagnosis but measurement of serial plasma tryptase in the acute phase is an useful adjunct. In patients with anaphylaxis attributed to an IgE-mediated allergy, sensitization can be confirmed by allergy skin testing and/or measurement of allergen specific IgE levels in serum. People prone to anaphylaxis are advised to have an "allergy action plan", and parents are advised to inform schools of their children's allergies and what to do in case of an anaphylactic emergency. The action plan usually includes use of epinephrine auto-injector, recommendation to wear a medical alert bracelet, and counseling on avoidance of triggers. © 2013 Nova Science Publishers, Inc.