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

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