Anaphylaxis and allergies
The amount of anaesthesia related anaphylaxis is 1:10,000 anaesthetics*. Death or permanent disability from anaphylaxis in anaesthesia can be avoided if the reaction is recognised early and managed well.
Read the NAP6 report, the largest ever prospective study of anaphylaxis related to anaesthesia and surgery.
The NAP6 review panel has also produced a range of resources to aid departments in preparation for the management of perioperative anaphylaxis.
The referral form and other resources are available on the NAP6 resources page.
Also, see the Quick Reference Handbook (QRH) guideline for more advice. The Resuscitation Council UK (RCUK) have launched their own guideline and supporting article. Their guideline is aligned with the QRH, so anaesthetists can use either. We know there are a minority of departments who have chosen not to implement the QRH, so the RCUK guide is an alternative.
You may also find the following points useful:
- Anaphylaxis should be considered if a patient develops hypotension or bronchospasm
- Initial management follows the ABC approach. Adrenaline is most effective and should be given as early as possible
- CPR as part of resuscitation should be considered (cardiac arrest or systolic BP < 50mmHg)
- It's the anaesthetist's responsibility to ensure the patient is referred for investigation
- Blood samples should be sent for analysis - serum mast cell tryptase levels support the retrospective diagnosis of anaphylaxis
- For further advice, see our list of allergy centres via the British Society of Allergists and Clinical Immunologists website
- Following specialist investigation, report cases to the MHRA through the Yellow Card Scheme and provide detailed information to the patient and general practitioner
- All departments of anaesthesia should have a consultant anaesthetist who is the clinical lead for anaesthetic anaphylaxis
- MedicAlert creates custom-made medical ID jewellery that is worn on the pulse point and enables emergency professionals to gain vital information from members' secure emergency personal records. Visit the MedicAlert website for more information
*Statistic from NAP6 report.