Management of Allergic Reactions and Anaphylaxis in the Emergency Department

Points & Pearls Excerpt

• Allergic reactions are a common cause of ED presentations, accounting for about 1% of U.S. visits annually.^4,5
• Up to 57% of anaphylactic reactions are not recognized, and in up to 80% of cases of anaphylaxis, patients were not given epinephrine.^4,6
• Many of the treatment recommendations considered to be standard of care in management of allergic reactions are based on weak or absent evidence.
• The NIAID/FAAN clinical criteria have been found to have a 95% sensitivity for diagnosing anaphylaxis.⁹ (See Table 1.)
• According to NIAID/FAAN criteria, if hypotension is present after exposure to a known allergen, involvement of a second organ system is not necessary to make the diagnosis of anaphylaxis.