Figure 5

Discharge management and prevention of future anaphylaxis recurrences in the community. Panel 1 describes management at the time of discharge after treatment of an acute anaphylactic episode in a healthcare setting. Panel 2: Anaphylaxis triggers suggested by the history of the acute episode should be confirmed by measurement of allergen-specific IgE levels (sometimes performed before discharge) and by allergen skin tests (generally performed 3-4 weeks after the acute anaphylactic episode); however, for most allergens, this time interval has not been definitively established in prospective studies. Patients with a convincing history of anaphylaxis and negative tests should therefore be retested weeks or months later. Panel 3 summarizes long-term risk reduction through avoidance of known confirmed triggers and where relevant, immunomodulation, for example, medication desensitization according to published protocols, or immunotherapy with appropriate standardized venom to prevent anaphylaxis recurrences from insect (Hymenoptera) stings ([2, 22–25, 32, 59, 68, 69, 72, 73, 76, 77, 87, 96, 97, 99, 132–139]).