Assessment and referral after emergency treatment of a suspected anaphylactic episode: summary of NICE guidance

Anaphylaxis is a severe, life threatening, generalized or systemic hypersensitivity reaction. It is characterized by rapidly developing, life threatening problems involving the airway (pharyngeal or laryngeal edema) and/or breathing (bronchospasm with tachypnea) and/or circulation (hypotension and/or tachycardia). UK estimates suggest that about 1 in 1,333 of the population in England has experienced anaphylaxis. A common trigger of anaphylaxis in children is food and in older people is medication. About 20 deaths from anaphylaxis are reported each year in the UK, of which about half are known to be iatrogenic, although this may be a substantial underestimate. Here, Dzingina et al summarize the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on assessment to confirm an anaphylactic reaction and on the decision to refer a patient after emergency treatment for a suspected anaphylactic reaction.