Suspected Anaphylactic Reactions Associated with Anaesthesia
Nigel J.N. Harper,T Dixon,P Dugué,D M Edgar,A Fay,H C Gooi,R Herriot,P Hopkins,J M Hunter,R Mirakian,Richard S. H. Pumphrey,S L Seneviratne,Andrew F. Walls,P Williams,J.A.W. Wildsmith,P Wood.,A S Nasser,R K Powell,R Mirakhur,Jasmeet Soar +19 more
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TLDR
This guidance recommends that all Departments of Anaesthesia should identify a Consultant Anaesthetist who is Clinical Lead for anaesthetic anaphylaxis, which is needed to recognise possible non-allergic causes for the ‘reaction’.Abstract:
Summary
(1) The AAGBI has published guidance on management of anaphylaxis during anaesthesia in 1990, 1995 and 2003. This 2008 update was necessary to disseminate new information.
(2) Death or permanent disability from anaphylaxis in anaesthesia may be avoidable if the reaction is recognised early and managed optimally.
(3) Recognition of anaphylaxis during anaesthesia is usually delayed because key features such as hypotension and bronchospasm more commonly have a different cause.
(4) Initial management of anaphylaxis should follow the ABC approach. Adrenaline (epinephrine) is the most effective drug in anaphylaxis and should be given as early as possible.
(5) If anaphylaxis is suspected during anaesthesia, it is the anaesthetist’s responsibility to ensure the patient is referred for investigation.
(6) Serum mast cell tryptase levels may help the retrospective diagnosis of anaphylaxis: appropriate blood samples should be sent for analysis.
(7) Specialist (allergist) knowledge is needed to interpret investigations for anaesthetic anaphylaxis, including sensitivity and specificity of each test used. Specialist (anaesthetist) knowledge is needed to recognise possible non-allergic causes for the ‘reaction’. Optimal investigation of suspected reactions is therefore more likely with the collaboration of both specialties.
(8) Details of specialist centres for the investigation of suspected anaphylaxis during anaesthesia may be found on the AAGBI website http://www.aagbi.org.
(9) Cases of anaphylaxis occurring during anaesthesia should be reported to the Medicines Control Agency and the AAGBI National Anaesthetic Anaphylaxis Database. Reports are more valuable if the diagnosis is recorded following specialist investigation of the reaction.
(10) This guidance recommends that all Departments of Anaesthesia should identify a Consultant Anaesthetist who is Clinical Lead for anaesthetic anaphylaxis.read more
Citations
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Journal ArticleDOI
European Resuscitation Council Guidelines for Resuscitation 2015
Gavin D. Perkins,Gavin D. Perkins,Anthony J. Handley,Rudolph W. Koster,Maaret Castrén,Michael Smyth,Theresa M. Olasveengen,Koenraad G. Monsieurs,Koenraad G. Monsieurs,Violetta Raffay,Jan-Thorsten Gräsner,Volker Wenzel,Giuseppe Ristagno,Jasmeet Soar,Leo Bossaert,Antonio Caballero,Pascal Cassan,Cristina Granja,Claudio Sandroni,David Zideman,Jerry P. Nolan,Ian Maconochie,Robert Greif +22 more
TL;DR: This chapter contains guidance on the techniques used during the initial resuscitation of an adult cardiac arrest victim and the use of an automated external defibrillator (AED).
Journal ArticleDOI
European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances
Anatolij Truhlář,Charles D. Deakin,Jasmeet Soar,Gamal Eldin Abbas Khalifa,A. Alfonzo,Joost J.L.M. Bierens,Guttorm Brattebø,Hermann Brugger,Joel Dunning,Silvija Hunyadi-Anticevic,Rudolph W. Koster,David Lockey,Carsten Lott,Peter Paal,Gavin D. Perkins,Claudio Sandroni,Karl-Christian Thies,David Zideman,Jerry P. Nolan +18 more
TL;DR: The guidelines for resuscitation in special circumstances section Collaborators1 are published on behalf of the Cardiac arrest in special ircumstances section Collaborator1.
Journal ArticleDOI
European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution.
Jasmeet Soar,Gavin D. Perkins,Gamal Abbas,A. Alfonzo,A. Barelli,Joost J.L.M. Bierens,Hermann Brugger,Charles D. Deakin,Joel Dunning,Marios Georgiou,Anthony J. Handley,David Lockey,Peter Paal,Claudio Sandroni,Karl-Christian Thies,David Zideman,Jerry P. Nolan +16 more
TL;DR: The guidelines for resuscitation of cardiac arrest in special circumstances in Europe focused on cardiac surgery, trauma, pregnancy, electrocution, and electlyte abnormalities and oisoning.
Journal ArticleDOI
The Helsinki Declaration on Patient Safety in Anaesthesiology.
TL;DR: The Helsinki Declaration on Patient Safety in Anaesthesiology represents a shared European view of that which is worthy, achievable, and needed to improve patient safety in anaesthesiology in 2010.
Journal ArticleDOI
Anaphylaxis and anesthesia: controversies and new insights.
TL;DR: The clinical diagnostic pathway necessary to distinguish anaphylaxis from confounding clinical diagnoses is identified and new therapeutic perspectives for the management of patients whose hemodynamic collapse is unresponsive to catecholamines, the initial recommended pharmacologic intervention are discussed.
References
More filters
Journal ArticleDOI
Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003.
S.G.O. Johansson,Thomas Bieber,Ronald Dahl,Peter S. Friedmann,Bobby Q. Lanier,Richard F. Lockey,C. Motala,José Antonio Ortega Martell,Thomas A.E. Platts-Mills,Johannes Ring,Frank P Thien,Paul Van Cauwenberge,Hywel C Williams +12 more
TL;DR: The nomenclatures proposed in the October 2003 report of the Nomenclature Review Committee of the World Allergy Organization is an update of the European Academy of Allergology and Clinical Immunology Revised NomenClature for Allergy Position Statement published in 2001.
Journal ArticleDOI
Lessons for management of anaphylaxis from a study of fatal reactions
TL;DR: The unpredictability of anaphylactic reactions and the need for immediate, often improvised treatment will make controlled trials impracticable; other means must therefore be used to determine optimal management.
Journal ArticleDOI
The diagnosis and management of anaphylaxis: an updated practice parameter.
Phillip Lieberman,Stephen F. Kemp,John Oppenheimer,David M. Lang,I. Leonard Bernstein,Richard A. Nicklas,John A. Anderson,David I. Bernstein,Jonathan A. Bernstein,Jordan N. Fink,Paul A. Greenberger,Dennis K. Ledford,James T. Li,Albert L. Sheffer,Roland Solensky,Bruce L. Wolf,Joann Blessing-Moore,David A. Khan,Rufus E. Lee,Jay M. Portnoy,Diane E. Schuller,Sheldon L. Spector,Stephen A. Tilles +22 more
TL;DR: These parameters were developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma and Immunology, the American College of Allergies, ASTI, and ACAAI as mentioned in this paper.
Journal ArticleDOI
Anaphylactic and Anaphylactoid Reactions Occurring during Anesthesia in France in 1999–2000
Paul-Michel Mertes,Marie-Claire Laxenaire,François Alla,Groupe d'Etudes des Réactions Anaphylactoïdes Peranesthésiques +3 more
TL;DR: The results of a 2-yr survey of reactions observed during anesthesia in France further corroborate the need for systematic screening in the case of anaphylactoid reaction during anesthesia and for the constitution of allergoanesthesia centers to provide expert advice to anesthesiologists and allergists.
Journal ArticleDOI
Anaphylaxis during anaesthesia. Results of a two‐year survey in France
Marie-Claire Laxenaire,Paul-Michel Mertes,Groupe d'Etudes des Réactions Anaphylactoïdes Peranesthésiques +2 more
TL;DR: Clinical reactions to neuromuscular blocking drugs were more severe than to latex, and the diagnostic value of specific IgE assays was confirmed, consistent with changes in the epidemiology of anaphylaxis related to anaesthesia.