Anaphylaxis: how to recognise and manage in primary care
Anaphylaxis is a life-threatening emergency. Hannah Kramer and Rebecca Batt explain how correct diagnosis, avoidance and patient education are fundamental in reducing risk
Anaphylaxis is a serious systemic hypersensitivity reaction that is usually rapid in onset and can cause death. It is an immune-mediated reaction, which typically occurs when a person is exposed to a trigger, for example a food, drug, or insect sting. This article aims to assist with the recognition of symptoms and to guide management of anaphylaxis in primary care. Beyond the acute, the practice nurse can play a key role in helping patients to manage their allergies in the long-term, particularly for those who are most vulnerable. Patients should be supported in understanding how best to avoid their triggers, in managing their emergency medication, and in the importance of good asthma control.
Anaphylaxis is an immune-mediated reaction, which typically occurs when a person is exposed to a trigger, for example a food, drug, or insect sting. Onset of symptoms after exposure to a trigger can be within minutes or up to several hours later – this can be influenced by the route of exposure to the trigger, or the amount of allergen they are exposed to. In some instances, there can be no trigger established: this is known as ‘idiopathic anaphylaxis’ (Resuscitation Council United Kingdom [RCUK], 2021).
Anaphylaxis can be defined as:
‘a serious systemic hypersensitivity reaction that is usually rapid in onset and may cause death. Anaphylaxis is characterized by potentially life-threatening compromise in airway, breathing and/or the circulation, and may occur without typical skin features or circulatory shock being present.’
It is estimated that 1 in 300 people in Europe will experience anaphylaxis in their lifetime (Panesar et al, 2013). The incidence of anaphylaxis has increased significantly in recent years; it is estimated that there are around 20 deaths each year due to anaphylaxis in the UK (Turner et al, 2015). Therefore, it is important that health professionals can recognise and manage this life-threatening emergency. It is recommended that staff who give immunisations should have annual updates in the treatment of anaphylaxis (RCUK, 2021).
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