Anaphylaxis is a medical emergency which may require resuscitation measures such as airway management, supplemental oxygen, large volumes of intravenous fluids, and close monitoring.
Epinephrine
Epinephrine (adrenaline) is the primary treatment for anaphylaxis with no absolute contraindication to its use. Epinephrine autoinjector is provided for self-prescription.
Intravenous fluids
Anaphylaxis can lead to massive losses of intravascular fluids. Thus large amounts of intravenous fluids maybe required.
- Steroids
Corticosteroids, are unlikely to make a difference in the current episode of anaphylaxis, but may be used in the hope of decreasing the risk of biphasic anaphylaxis. How effective they are at achieving this, however, is uncertain.
Preparedness
People prone to anaphylaxis are advised to have an "allergy action plan", and parents are advised to inform schools, etc., of their children's allergies and what to do in case of an anaphylactic emergency.
The action plan usually includes use of epinephrine auto-injectors, the recommendation to wear a medical alert bracelet, and counseling on avoidance of triggers. Immunotherapy is available for certain triggers to prevent future episodes of anaphylaxis.
A multi–year course of subcutaneous desensitization has been found effective against stinging insects while oral desensitization is effective for many foods.
The risk is greatest in young people and females. The trigger in the young is usually food related while in adults, medications and insect venoms are more common causes.
Due in part to the variety of definitions, between 1% and 15% of the population of the United States can be considered "at risk" for having an anaphylactic reaction if they are exposed to one or more allergens, especially penicillin and insect stings.
Most of these people successfully avoid their allergens and will never experience anaphylaxis. Of those people who actually experience anaphylaxis, up to 1% may die as a result.[ ]
[Anaphylaxis results in approximately 1,500 deaths per year in the U.S.][ (one out of every 1,600 of the 2.4 million deaths from all causes each year in the U.S.;][). ]
[The most common presentation includes sudden cardiovascular collapse (88% of reported cases of severe anaphylaxis). In England, mortality rates for anaphylaxis have been reported as up to 0.05 per 100,000 population, or around 10-20 a year.][ ]
[Anaphylactic reactions requiring hospital treatment appear to be increasing, with authorities in England reporting a threefold increase between 1994 and 2004.]
Further Reading
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