Managing Anaphylaxis in the Emergency Department Contents
- Executive Summary
This guideline is the key for the initial management of anaphylaxis (a life-threatening condition compromising the airway, breathing, and/or circulation) in the emergency department (ED), to be used by emergency physicians and any physician who works in the ED, whatever the specialty. It has been made in a simple concise way to go through in a quick stepping manner giving the clues to most critical points of such a critical condition in the ED.
The guideline was developed through adoption and adaptation methodology by a consensus of expert field group, Guideline Development Group (GDG) of the Egyptian National Clinical Guidelines Centre, supporting the 2021 update of the Resuscitation Council United Kingdom (RCUK). Because of lacking randomized clinical trials, the certainty of evidence for these recommendations was moderate or less.
We recommend Strength 1- giving
adrenaline as the first line of treatment Strong 2- early
administration of adrenaline once symptoms of anaphylaxis are recognized or
suspected Weak 3- giving
adrenaline by intramuscular route as the initial treatment of anaphylaxis Strong 4- following the
list of adrenaline doses according to age Strong 5- repeating
intramuscular adrenaline every 5-15 min in cases of refractory anaphylaxis Weak 6- iv bolus of
crystalloid in case of hemodynamic instability and in refractory anaphylaxis Weak 7- against using
antihistamines as initial treatment of anaphylaxis Weak 8- against using
corticosteroids in initial treatment of anaphylaxis Weak 9 - giving
inhalational beta2 agonist as part of treatment in the presence of wheezy
chest Weak 10- a minimum of
6 hours of observation after resolution of symptoms for all patients with a
confirmed diagnosis. Weak