Anaphylaxis *

Objectives (EM)

1. In any patient presenting with shock, consider anaphylaxis as a possible diagnosis.
2. In a patient with symptoms and signs suggestive of anaphylaxis, recognize and make the diagnosis even when the presentation is incomplete (e.g., may exhibit only some of rash/hypotension/vomiting/wheezing/altered level of consciousness).
3. Given a patient with a diagnosis of anaphylaxis, treat rapidly and aggressively by giving epinephrine appropriately and managing the airway early as required, and with timely IV access and appropriate fluid resuscitation.
4. When discharging a patient after the resolution of an anaphylactic reaction, as part of the treatment plan prescribe appropriate emergency self-rescue medication (e.g., epinephrine), educate appropriately (MedicAlert, rebound symptoms, precipitant avoidance), and arrange follow-up (e.g., allergy testing/desensitization).