Abbas AK, Lichtman AH, Pillai S. Cellular and molecular immunology, 9th edn. Beijing, China: Elsevier; 2018

Australasian Society of Clinical Immunology and Allergy. Guideline for the acute management of anaphylaxis. 2020. (accessed: 14 October 2021)

Baseggio Conrado A, Ierodiakonou D, Gowland MH, Boyle RJ, Turner PJ. Food anaphylaxis in the United Kingdom: analysis of national data, 1998-2018. BMJ. 2021a; 372

Baseggio Conrado A, Patel N, Turner PJ. Global patterns in anaphylaxis due to specific foods: a systematic review. J Allergy Clin Immunol. 2021b;

Cardona V, Ansotegui IJ, Ebisawa M World Allergy Oorganization anaphylaxis guidance 2020. World Allergy Organ J. 2020; 13:(10)

Delves PJ, Martins SJ, Burton DR, Roitt IM. Roitt's essential immunology, 13th edn. Chichester: Wiley Blackwell; 2017

Galli SJ, Tsai M. Mast cells in allergy and infection: versatile effector and regulatory cells in innate and adaptive immunity. Eur J Immunol. 2010; 40:(7)1843-1851

Harper NJN, Cook TM, Garcez T Anaesthesia, surgery, and life-threatening allergic reactions: epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project (NAP6). Br J Anaesth. 2018; 121:(1)159-171

Helbert M. Immunology for medical students, 3rd edn. Philadelphia (PA): Elsevier; 2017

Kraft S, Kinet JP. New developments in FceRI regulation, function and inhibition. Nat Rev Immunol. 2007; 7:(5)365-78

Lott C, Truhlár A, Alfonzo A European Resuscitation Council Guidelines 2021: cardiac arrest in special circumstances. Resuscitation. 2021; 161:152-219

Mangan NE, Fallon RE, Smith P, van Rooijen N, McKenzie AN, Fallon PG. Helminth infection protects mice from anaphylaxis via IL-10-producing B cells. J Immunol. 2004; 173:(10)6346-6356

Nadeau KC, Kohli A, Iyengar S, DeKruyff RH, Umetsu DT. Oral immunotherapy and anti-IgE antibody-adjunctive treatment for food allergy. Immunol Allergy Clin North Am. 2012; 32:(1)111-133

NHS Digital. Statistics on hospital admissions with the primary diagnosis of anaphylactic shock and allergies broken down at age at provider and national level, for the period January 2015 to December 2020. 2021. (accessed 14 October 2021)

National Institute for Health and Care Excellence. Anaphylaxis. Assessment to confirm anaphylactic episode and the decision to refer after emergency treatment for a suspected anaphylactic reaction. Clinical guideline 134. 2020. (accessed 14 October 2021)

Panesar SS, Javad S, de Silva D The epidemiology of anaphylaxis in Europe: a systematic review. Allergy. 2013; 68:(11)1353-1361

Fatal anaphylaxis in the UK, 1992-2001. Novartis Foundation Symposium. 2004. (accessed 14 October 2021)

Pumphrey RS, Gowland MH. Further fatal allergic reactions to food in the United Kingdom, 1999-2006. J Allergy Clin Immunol. 2007; 119:(4)1018-1019

Resuscitation Council UK. Emergency treatment of anaphylaxis for healthcare providers. 2021. (accessed 14 October 2021)

Sheikh A, Shehata YA, Brown SG, Simons FE. Adrenaline for the treatment of anaphylaxis: Cochrane systematic review. Allergy. 2009; 64:(2)204-212

Tejedor-Alonso MA, Farias-Aquino E, Pérez-Fernández E, Grifol-Clar E, Moro-Moro M, Rosado-Ingelmo A. Relationship between anaphylaxis and use of beta-blockers and angiotensin-converting enzyme inhibitors: a systematic review and meta-analysis of observational studies. J Allergy Clin Immunol Pract. 2019; 7:(3)879-897.e5

Turner PJ, Gowland MH, Sharma V Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992-2012. J Allergy Clin Immunol. 2015; 135:(4)956-963.e1

Turner PJ, Jerschow E, Umasunthar T, Lin R, Campbell DE, Boyle RJ. Fatal anaphylaxis: mortality rate and risk factors. J Allergy Clin Immunol Pract. 2017; 5:(5)1169-1178

Turner PJ, Worm M, Ansotegui IJ Time to revisit the definition and clinical criteria for anaphylaxis?. World Allergy Organ J. 2019; 12:(10)

Yu JE, Lin RY. The epidemiology of anaphylaxis. Clin Rev Allergy Immunol. 2018; 54:(3)366-374

Managing anaphylaxis in adults

28 October 2021
8 min read
Volume 30 · Issue 19


Anaphylaxis is a severe and potentially life-threatening allergic reaction. The recognition and treatment of anaphylaxis remains complex and an area of continued professional development for health professionals. Prompt recognition of anaphylaxis and its subsequent treatment and management by the multidisciplinary team, including nurses and allied health professionals, is key as this increases the patient's chances of survival. Evidence-based clinical information on managing anaphylaxis will enable health professionals to provide safer patient care.

According to the World Allergy Organization's anaphylaxis guidance, anaphylaxis can be defined as:

‘A serious multi-systemic hypersensitivity reaction that is usually rapid in onset and may result in death.’

Cardona et al, 2020

Turner et al (2019) stated that severe anaphylaxis is characterised by a potentially life-threatening compromise of the airway, breathing and/or the circulation, and may occur without typical skin features or circulatory shock being present. Anaphylactic reactions can be fatal within minutes. It is therefore essential that health professionals recognise the signs and symptoms of a reaction and implement the correct treatment immediately (Resuscitation Council UK (RCUK), 2021).

The aim of this article is to discuss the immediate emergency management and post-emergency management of an adult patient experiencing an anaphylactic reaction.

Anaphylactic episodes are increasing within the UK, with growing numbers of people presenting to hospitals. Between 2018 and 2019, data revealed that there were 3864 hospital admissions due to anaphylactic shock in adult patients, an increase on 3337 hospital admissions in 2015 to 2016 (NHS Digital, 2021) Overall, both adult and child admissions were 4482 in 2015-2016 and 5534 in 2018-2019).

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