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Anaphylaxis: assessment and referral after emergency treatment

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Last updated:23rd Aug 2020
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Anaphylaxis: assessment and referral after emergency treatment

Anaphylaxis may be an allergic response that is immunologically mediated, or a non-immunologically mediated response, or idiopathic. Certain foods, insect venoms, some drugs and latex are common precipitants of immunoglobulin E (IgE)-mediated allergic anaphylaxis. Many drugs can also act through non-allergic mechanisms. A significant proportion of anaphylaxis is classified as idiopathic, in which there are significant clinical effects but no readily identifiable cause. The relative likelihood of the reaction being allergic, non-allergic or idiopathic varies considerably with age.

Food is a particularly common trigger in children, while medicinal products are much more common triggers in older people. In the UK it is estimated that 500,000 people have had a venom-induced anaphylactic reaction and 220,000 people up to the age of 44 have had a nut-induced anaphylactic reaction.

This guideline covers assessment and referral for anaphylaxis. It aims to improve the quality of care for people with suspected anaphylaxis by detailing the assessments that are needed and recommending referral to specialist allergy services.

In August 2020, we added advice on prescribing adrenaline injectors before discharge after emergency treatment.

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