Allergies and anaphylaxis

Death or permanent disability from anaphylaxis in anaesthesia may be avoidable if the reaction is recognised early and managed optimally.

  • Consider anaphylaxis 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.
  • It is the anaesthetist’s responsibility to ensure the patient is referred for investigation.
  • Serum mast cell tryptase levels may help the retrospective diagnosis of anaphylaxis: appropriate blood samples should be sent for analysis.
  • Optimal investigation of suspected reactions is more likely with the collaboration of specialist allergists and anaesthetists.
  • A list of allergy centres can be downloaded here or via the British Society of Allergists and Clinical Immunologists website with interactive search map
  • Following specialist investigation, report cases to the MHRA through the Yellow Card Scheme
  • All Departments of Anaesthesia should identify a Consultant Anaesthetist who is Clinical Lead for anaesthetic anaphylaxis.
  • Medic Alert - MedicAlert creates custom-made medical ID jewellery. Worn on the pulse point, and carrying the international medical symbol, the ID jewellery enables emergency professionals to gain vital information from members’ secure emergency personal records. visit the MedicAlert website


The Yorkshire Allergy pack has been assembled by Drs Louise Savic and Maria Garside and has been uploaded here for general use by departments. The pack includes a simple checklist for what to do to ensure the patient receives appropriate investigation and follow up and letter templates, which can be downloaded here:

Checklist »

Form A: Allergist / Immunologist (NAP6 referral form) »

Form B: General Practitioner letter »

Form C: Patient letter »