Skip to main content

Advertisement

Table 5 Anaphylaxis in community settings: summary of collaborating organizations’ principal anaphylaxis guidelines 1

From: International consensus on (ICON) anaphylaxis

  WAO Guidelines AAAAI/ACAAI Guidelines EAACI Guidelines
Post-discharge management of patients treated for acute anaphylaxis prescribe epinephrine IM through auto-injector; anaphylaxis emergency action plan; medical ID stating triggers and co-morbidities; Table 9, Figure 5 prescribe epinephrine IM through auto-injector; anaphylaxis emergency action plan; medical ID; “an action plan is an important component of follow-up”; Figure E1 prescribe epinephrine IM through auto-injector; provide discharge advice sheet; provide specialist referral and contact information for patient support groups; Boxes 7, 9, 10, 11, 12, 13, 14, 15
Investigations by allergy/ immunology specialists to confirm anaphylaxis triggers state the importance of the history of the episode; describe skin prick tests (intradermal tests needed for venom and drug-triggered anaphylaxis); investigations in idiopathic anaphylaxis; additional tests when needed to distinguish allergen sensitization from clinical risk in patients with food or drug allergy; Table 9, Figure 5 describe investigations in detail under different triggers; describe investigations in idiopathic anaphylaxis; details on skin testing with anesthetic agents; Table E8 state “validated in vivo and/or in vitro tests should be interpreted in the light of a detailed allergy history”; additional information re investigations to confirm food triggers is published separately in the EAACI Food Allergy Guidelines
Prevention of anaphylaxis recurrences describe allergen avoidance (food, stinging insects, drugs, latex, etc.); immunotherapy with standardized insect venoms; and desensitization to drugs; mention food OIT2; describe pharmacologic prophylaxis of RCM anaphylaxis and idiopathic anaphylaxis; Table 9, Figure 5 describe specific avoidance measures under triggers; describe venom immunotherapy and desensitization to drugs; describe pharmacologic prophylaxis of RCM anaphylaxis and idiopathic anaphylaxis; Table E6; Figure E1 describe food avoidance; venom immunotherapy and desensitization to drugs; mention food OIT2; describe pharmacologic prophylaxis of anaphylaxis to RCM and snake anti-venom; Boxes 8, 9, 15; online supplement
Anaphylaxis education and training outline principles of anaphylaxis education provide relevant information under various triggers; give examples of print resources; Figure E1 major emphasis on all aspects of anaphylaxis training and adrenaline auto-injector prescription; Boxes 9, 10, 11, 12, 13, 14, 15; online supplement
Follow-up with physician yearly review of EAI use, action plan, optimal management of co-morbid diseases, adjustment of concurrent medications as needed, allergen avoidance, and immune modulation review discharge management, allergen avoidance, and immune modulation major emphasis; include recommendations for training, management plan, and if relevant, help from nutritionists and psychologists; Boxes 9, 15; online supplement
  1. 1For details, see ICON: Anaphylaxis text pages 8-9 and references 2, 3, and 4, including the tables, figures, boxes, and online supplemental materials from these references that are mentioned above in this Table.
  2. 2Described but not recommended for clinical implementation at this time.
  3. EAI, epinephrine auto-injector; ID, identification; IM, intramuscular; OIT, oral immunotherapy; RCM, radiocontrast media.