From: World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis
Medication |
   Epinephrine/adrenaline auto-injectora |
   Epinephrine from an ampule/syringeb or prefilled syringec (alternative but not preferred formulations) |
Other aspects of discharge management |
   Anaphylaxis emergency action plan (personalized, written) |
   Medical identification (eg, bracelet, wallet card) |
   Medical record electronic flag (or chart sticker) |
   Emphasize the importance of follow-up, preferably with an allergy/immunology specialist |
Assessment of sensitization to allergen |
   Before discharge, consider assessing sensitization to allergens suggested in the history of the acute episode, by measuring serum IgE levels to relevant allergen(s), if the test is availabled |
   3-4 weeks after the episode, confirm allergen sensitization using skin testse |
   Challenge/provocation tests might be needed in some patients, for example, with food or medication allergy, in order to assess risk of future anaphylactic episodes furtherf |
Long-term risk reduction: avoidance and/or immunomodulation |
   Food-triggered anaphylaxis: avoidance of relevant food(s) |
   Stinging insect-triggered anaphylaxis: avoidance of stinging insects; subcutaneous venom immunotherapy (protects up to 80-90% of adults and 98% of children) |
   Medication-triggered anaphylaxis: avoidance of relevant medications; if indicated, medically supervised desensitization in a healthcare setting according to published protocols |
   Idiopathic anaphylaxis: for frequent episodes, consider glucocorticoid and H1-antihistamine prophylaxis for 2-3 months |
Optimal management of asthma and other concomitant diseases |