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PACULit - Anaphylaxis: 2020 Practice Parameter Update

Anaphylaxis: 2020 Practice Parameter Update

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Executive Summary

Anaphylaxis is an acute, life-threatening systemic allergic reaction with a wide range of clinical manifestations. The National Institute of Allergy and Infectious Diseases (NIAID) clinical criteria from 2006 continue to provide a helpful framework for approaching patients with acute allergic symptoms.

1. Definition and Diagnosis

This section outlines the criteria for diagnosing anaphylaxis and discusses the challenges in identifying atypical presentations.

Recommendation Quality of Evidence
Use NIAID clinical criteria for diagnosing anaphylaxis Moderate
Consider atypical presentations in specific populations Low

2. Acute Management

This section covers the immediate treatment steps for anaphylaxis, focusing on epinephrine administration and supportive care.

Recommendation Quality of Evidence
Administer epinephrine as first-line treatment High
Use intramuscular route for epinephrine administration Moderate
Monitor patients for at least 4-6 hours after symptom resolution Low

3. Long-term Management

This section discusses strategies for preventing future anaphylactic episodes and managing patients with a history of anaphylaxis.

Recommendation Quality of Evidence
Prescribe epinephrine auto-injector for outpatient use Moderate
Refer patients to an allergist for follow-up Moderate
Provide patient education on trigger avoidance Low

4. Special Considerations

This section addresses anaphylaxis management in specific populations or situations, such as pregnancy, infants, and the elderly.

No specific recommendations are provided for this section, but clinicians should be aware of potential modifications to standard management approaches in these populations.

Anaphylaxis Management Workflow

Anaphylaxis Management Workflow