Anaphylaxis

Publication Date: December 17, 2023

Introduction

Introduction

This practice parameter is not a comprehensive review of anaphylaxis but focuses on 7 areas in which new evidence has emerged and in which recommendations may now be different from previous practice parameters.
  • Diagnosis
  • Infants and Toddlers
  • Anaphylaxis in Community Settings
  • Epinephrine Autoinjectors
  • Beta-blockers and ACE inhibitors
  • Mast Cell Disorders, and
  • Peri-operative Anaphylaxis

Diagnosis

Diagnosi...

...of Consensus in the Definition, Criteria,...

...Anaphylaxis is a serious, systemic h...


...04 Brown Grading System for Hyperse...


...ecommendation 1 (CBS)We recommend obtain...


...tion 2 (CBS) We suggest drawing an ac...


...3 (CBS)We suggest clinicians consider evaluation...


...mmendation 4 (CBS)We suggest clinicia...


...5 (CBS)We suggest that clinicians consider a...


...6 (CBS)We suggest that meeting diagnos...


...ndation 7 (CBS)We suggest that neither the clinica...


...re 1. Anaphylaxis Consensus Severity Grading...


...re 2. Diagnostic Evaluation of the Patient With...


...hylaxis Differential DiagnosisAnaphylaxis...


...gure 3. Scoring Systems to Evaluate Risk of a Cl...


Infants and Toddlers

...ts and Toddler...

...hylaxis in Infants and Todd...

...(CBS)We suggest that clinicians use current NIAID...

...endation 9 (CBS)We suggest clinicians be...

...ecommendation 10 (CBS)We suggest clinicians b...

...mendation 11 (CBS)We suggest clinicia...

...2 (CBS)We suggest clinicians prescribe eith...


Anaphylaxis in Community Settings

...in Community Settings...

...endation 13 (CBS)We recommend clinici...


...ecommendation 14 (CBS)We recommend...


...ndation 15 (CBS)We recommend clinicia...


...3. Frequency of Anaphylaxis in Di...


...aphylaxis in Childcare Centers and Schoo...

...dation 16 (GRADE)We suggest childcare centers...

...n 17 (GRADE)We suggest that childcare cen...

...n 18 (GRADE)We suggest that childcare cent...


...s in the Restaurant Setting...

...on 19 (CBS)We suggest clinicians c...

...dation 20 (CBS)We suggest clinicians counsel patie...


...in Community Recreational Settings...

...ndation 21 (CBS)We suggest that advisin...


Stock Epinephrine in Community...

...ndation 22 (CBS)We suggest that keeping stock EAI...


...e 4. Potential Expert Opinion-Based Strategies an...


.... Key Points for the Clinician on Anaphylaxi...


Epinephrine Autoinjectors

...inephrine Autoinject...

...hrine Autoinjectors: When and What to Prescribe...

...ndation 23 (CBS)We suggest clinicians routinely...

...tion 24 (CBS)We suggest that in jurisdictions w...

...mendation 25 (CBS)We suggest that clinicians...

...ndation 26 (CBS)We suggest that clinicians...

.... Likelihood of Requiring Treatment With Prescrib...

...able 7. Risk Factors and Cofactors Potentially...

...e 4. General Guidance for Activation of EMS and Ad...

...siderations for and Against Home Management...

...Proposed Strategies to Reduce the Risk of EAI-Re...

...27 (CBS)Serious adverse reactions to int...

...28 (CBS)We suggest that clinicians dis...

...ation 29 (CBS)When deciding which EAI to prescrib...

...30 (CBS)During visits with patients who...


Beta-blockers and ACEIs

...lockers and ACEIs...

...(BB) and Angiotensin-Converting Enzyme Inh...

...ramework for Evaluation of the Benefit a...


...ect Allergy and Venom Immunotherapy...

...31 (CBS)We suggest that patients with...

...2 (CBS)We suggest that VIT may be prescribed for...

...commendation 33 (CBS)We suggest, in most...


Allergen Immunother...

...34 (CBS)We suggest use of initial...

...ommendation 35 (CBS)We suggest that pat...


...dures: (e.g., Drug Desensitization, Radiocontrast...

...commendation 36 (CBS)For planned procedures (e....


...atients at Risk for Anaphylaxis (Unplanned...

...ecommendation 37 (CBS)We suggest tha...


Mast Cell Disorders

...ell Disorders...

...ation 38 (CBS)We recommend clinicians...


...9 (CBS)We recommend clinicians not r...


...e 11. Differential Diagnosis for Elevated Bas...


...on 40 (CBS)We recommend measurement of bST in p...


...ecommendation 41 (CBS)We suggest clinic...


...2 (CBS)We suggest VIT be continued...


Perioperative Anaphylaxis

...rioperative Anaphy...

...ion 43 (CBS)We suggest that immediate hyperse...


...mendation 44 (CBS)We suggest that imme...


Recommendation 45 (CBS)We suggest tha...


...6 (CBS)We suggest that repeat anesthe...


...tion 47 (CBS)We suggest that avoidanc...


...commendation 48 (CBS)We offer no recommendatio...


Table 12. Recommended Concentrations for Ski...