Feature Article

Updated anaphylaxis guidelines: a summary for primary care

Feature Article

Updated anaphylaxis guidelines: a summary for primary care

Katie Frith, Preeti Joshi

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© KOZOROG/ISTOCKPHOTO.COM
© KOZOROG/ISTOCKPHOTO.COM

Abstract

Anaphylaxis is occurring more frequently in Australia and the rate of fatal reactions is increasing. Prompt recognition and early treatment with intramuscular adrenaline can reduce the risk of death.

Key Points

  • Anaphylaxis is a potentially life-threatening allergic reaction that can affect people of any age, including infants.
  • Anaphylactic reactions can be unpredictable and may initially present with mild symptoms.
  • Rates of hospital admission for anaphylaxis and fatalities from anaphylaxis are increasing in Australia.
  • Adrenaline is the first-line treatment for anaphylaxis and should be given without delay by intramuscular injection into the outer mid-thigh; there are no contraindications for adrenaline in the management of anaphylaxis.
  • Correct positioning of a patient with anaphylaxis is essential, as an upright posture is a risk factor for fatal reactions.
  • Adrenaline injectors (AIs) allow easy, prompt administration of adrenaline and are designed to be used by people without medical training. There are two AI devices available in Australia on the PBS.
  • The Australasian Society of Clinical Immunology and Allergy (ASCIA) now recommends a 150mcg AI can be prescribed for infants weighing from 7.5 to 20kg; children weighing 20kg or more should be prescribed a 300mcg AI, and from around 12 years (if weight greater than 50kg) either a 300mcg or 500mcg AI is recommended.
  • ASCIA has recently updated its guidelines for the acute management of anaphylaxis and has also updated its e-learning courses and anaphylaxis resources in line with current evidence.