Emergency treatment of anaphylactic reactions -: Guidelines for healthcare providers

被引:227
作者
Soar, Jasmeet [1 ]
Pumphrey, Richard [2 ]
Cant, Andrew [3 ]
Clarke, Sue [4 ]
Corbett, Allison [5 ]
Dawson, Peter
Ewan, Pamela [6 ]
Foex, Bernard [7 ]
Gabbott, David [8 ]
Griffiths, Matt [9 ]
Hall, Judith [10 ]
Harper, Nigel [11 ]
Jewkes, Fiona [12 ]
Maconochie, Ian [13 ]
Mitchell, Sarah
Nasser, Shuaib [14 ]
Nolan, Jerry [15 ]
Rylance, George [16 ]
Sheikh, Aziz [17 ]
Unsworth, David Joseph [1 ]
Warrell, David [18 ]
机构
[1] Southmead Gen Hosp, N Bristol NHS Trust, Bristol BS10 5NB, Avon, England
[2] Cent Manchester & Manchester Childrens Hosp, Manchester M13 9WL, Lancs, England
[3] Newcastle Gen Hosp, Newcastle Upon Tyne NE4 6BE, Tyne & Wear, England
[4] Community Hlth Clin, Royston SG8 6HH, Herts, England
[5] Royal Pharmaceut Soc GB, British Natl Formulary, London SE1 7JN, England
[6] Univ Cambridge, NHS Fdn Trust, Cambridge CB2 0QQ, England
[7] Manchester Royal Infirm, Manchester M13 9WL, Lancs, England
[8] Gloucestershire Royal Hosp, Gloucester GL1 3NN, England
[9] Royal Coll Nursing UK, London W1G 0RN, England
[10] Cardiff Univ, Dept Anaesthet & Intens Care Med, Cardiff CF14 4XN, S Glam, Wales
[11] Manchester Royal Infirm, Anaesthet React Clin, Manchester M13 9WL, Lancs, England
[12] Ambulance Serv Assoc, London SE1 8RT, England
[13] St Marys Hosp NHS Trust, London W2 1NY, England
[14] Univ Cambridge, NHS Fdn Trust, Cambridge CB2 0QQ, England
[15] Royal United Hosp, Bath BA1 3NG, Avon, England
[16] Royal Victoria Infirm, Newcastle Upon Tyne NE1 4LP, Tyne & Wear, England
[17] Univ Edinburgh, Gen Practice Sect Div Community Hlth Sci, Edinburgh EH8 9DX, Midlothian, Scotland
[18] John Radcliffe Hosp, Oxford OX3 9DU, England
关键词
anaphylactic reactions; treatment;
D O I
10.1016/j.resuscitation.2008.02.001
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The UK incidence of anaphylactic reactions is increasing. Patients who have an anaphylactic reaction have life-threatening airway and, or breathing and, or circulation problems usually associated with skin or mucosal changes. Patients having an anaphylactic reaction should be treated using the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. Anaphylactic reactions are not easy to study with randomised controlled trials. There are, however, systematic reviews of the available evidence and a wealth of clinical experience to help formulate guidelines. The exact treatment will depend on the patient's location, the equipment and drugs available, and the skills of those treating the anaphylactic reaction. Early treatment with intramuscular adrenaline is the treatment of choice for patients having an anaphylactic reaction. Despite previous guidelines, there is still confusion about the indications, dose and route of adrenaline. Intravenous adrenaline must only be used in certain specialist settings and only by those skilled and experienced in its use. All those who are suspected of having had an anaphylactic reaction should be referred to a specialist in allergy. Individuals who are at high risk of an anaphylactic reaction should carry an adrenaline auto-injector and receive training and support in its use. There is a need for further research about the diagnosis, treatment and prevention of anaphylactic reactions. (C) 2008 Resuscitation Council (UK). Published by Elsevier Ireland Ltd.
引用
收藏
页码:157 / 169
页数:13
相关论文
共 75 条
[1]  
Alves B, 2001, ARCH DIS CHILD, V85, P349
[2]  
[Anonymous], 2004, NOVARTIS FOUND SYMP
[3]  
[Anonymous], NOVARTIS FDN S
[4]   Epinephrine fails to hasten hemodynamic recovery in fully developed canine anaphylactic shock [J].
Bautista, E ;
Simons, FER ;
Simons, KJ ;
Becker, AB ;
Duke, K ;
Tillett, M ;
Kepron, W ;
Mink, SN .
INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY, 2002, 128 (02) :151-164
[5]   European Resuscitation Council Guidelines for Resuscitation 2005 - Section 6. Paediatric life support [J].
Biarent, D ;
Bingham, R ;
Richmond, S ;
Maconochie, I ;
Wyllie, J ;
Simpson, S ;
Nunez, AR ;
Zideman, D .
RESUSCITATION, 2005, 67 :S97-S133
[6]   Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization [J].
Bohlke, K ;
Davis, RL ;
DeStefano, F ;
Marcy, SM ;
Braun, MM ;
Thompson, RS .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2004, 113 (03) :536-542
[7]  
Brown AFT, 1998, J ACCID EMERG MED, V15, P89
[8]   Emergency department anaphylaxis: A review of 142 patients in a single year [J].
Brown, AFT ;
McKinnon, D .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2001, 108 (05) :861-866
[9]   Cardiovascular aspects of anaphylaxis: implications for treatment and diagnosis [J].
Brown, SGA .
CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY, 2005, 5 (04) :359-364
[10]   Clinical features and severity grading of anaphylaxis [J].
Brown, SGA .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2004, 114 (02) :371-376