Allergies and anaphylaxis

The estimated incidence of anaesthesia related anaphylaxis is 1:10,000 anaesthetics (NAP6 report). Death or permanent disability from anaphylaxis in anaesthesia may be avoidable if the reaction is recognised early and managed optimally. The Quick Reference Handbook (QRH) guideline is designed to support the anaesthesia team response. You may also find the following points useful:

  • 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
  • The need for 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
  • Serum mast cell tryptase levels support the retrospective diagnosis of anaphylaxis: appropriate blood samples should be sent for analysis
  • Optimal investigation of suspected reactions requires the collaboration of specialist allergists and anaesthetists
  • View a list of allergy centres 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 and provide detailed information of the incident and investigation outcome to the patient and general practitioner
  • All Departments of Anaesthesia should identify a Consultant Anaesthetist who is Clinical Lead for anaesthetic anaphylaxis
  • 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 for more information