Anaphylaxis: 2020 Practice Parameter Update
Executive Summary
Anaphylaxis is an acute, life-threatening systemic allergic reaction with a wide range of clinical manifestations. The National Institute of Allergy and Infectious Diseases (NIAID) clinical criteria from 2006 continue to provide a helpful framework for approaching patients with acute allergic symptoms.
1. Definition and Diagnosis
This section outlines the criteria for diagnosing anaphylaxis and discusses the challenges in identifying atypical presentations.
| Recommendation | Quality of Evidence |
|---|---|
| Use NIAID clinical criteria for diagnosing anaphylaxis | Moderate |
| Consider atypical presentations in specific populations | Low |
2. Acute Management
This section covers the immediate treatment steps for anaphylaxis, focusing on epinephrine administration and supportive care.
| Recommendation | Quality of Evidence |
|---|---|
| Administer epinephrine as first-line treatment | High |
| Use intramuscular route for epinephrine administration | Moderate |
| Monitor patients for at least 4-6 hours after symptom resolution | Low |
3. Long-term Management
This section discusses strategies for preventing future anaphylactic episodes and managing patients with a history of anaphylaxis.
| Recommendation | Quality of Evidence |
|---|---|
| Prescribe epinephrine auto-injector for outpatient use | Moderate |
| Refer patients to an allergist for follow-up | Moderate |
| Provide patient education on trigger avoidance | Low |
4. Special Considerations
This section addresses anaphylaxis management in specific populations or situations, such as pregnancy, infants, and the elderly.
No specific recommendations are provided for this section, but clinicians should be aware of potential modifications to standard management approaches in these populations.