Second Symposium on the Definition and Management of Anaphylaxis: Summary Report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium

Sampson, Hugh A.; Muñoz-Furlong, Anne; Campbell, Ronna L.; Adkinson, N. Franklin; Bock, S. Allan; Branum, Amy M.; Brown, Simon G A; Camargo, Carlos A.; Cydulka, Rita K.; Galli, Stephen J.; Gidudu, Jane; Gruchalla, Rebecca S.; Harlor, Allen D. “Buz”; Hepner, David L.; Lewis, Lawrence M.; Lieberman, Phillip; Metcalfe, Dean D.; O’Connor, Robert E.; Muraro, Antonella; Rudman, A. R.; Schmitt, Cara; Scherrer, Debra; Simons, F. E. R.; Thomas, Stephen R.; Wood, Joseph P.; Decker, Wyatt W.

doi:10.1016/j.annemergmed.2006.01.018

Cited by 975 publications

(1,212 citation statements)

References 43 publications

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“…Thirty-two of 196 (16.3%) respondents stated that their EDs used a definition based on an established set of criteria (question 2): 17 of these respondents (8.9% of the total) reported using definitions based on consensus criteria recommended by the NIAID/FAAN 2nd Symposium[5] (1.6%), the 2010 US Practice Parameters[4] (4.2%), or the WAO guidelines[3,6] (3.1%) as the source of their definition.…”

Section: Resultsmentioning

confidence: 99%

“…Are the current clinical criteria for identifying anaphylaxis as published in the National Institutes of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network (NIAID/FAAN) 2 nd Symposium,[5] the 2010 US Practice Parameters,[4] or the World Allergy Organization (WAO) Guidelines,[3,6] being applied in clinical practice? Treatment. Is epinephrine being used as the first-line agent for treating all episodes of anaphylaxis-even those with mild or single system symptoms and those in which the diagnosis is only suspected?…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the management of anaphylaxis in US emergency departments: Guidelines vs. practice

Russell

Farrar

Nowak

et al. 2013

World Journal of Emergency Medicine

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BACKGROUND:Anaphylaxis is characterized by acute episodes of potentially life-threatening symptoms that are often treated in the emergency setting. Current guidelines recommend: 1) quick diagnosis using standard criteria; 2) first-line treatment with epinephrine; and 3) discharge with a prescription for an epinephrine auto-injector, written instructions regarding long-term management, and a referral (preferably, allergy) for follow-up. However, studies suggest low concordance with guideline recommendations by emergency medicine (EM) providers. The study aimed to evaluate how emergency departments (EDs) in the United States (US) manage anaphylaxis in relation to guideline recommendations.METHODS:This was an online anonymous survey of a random sample of EM health providers in US EDs.RESULTS:Data analysis included 207 EM providers. For respondent EDs, approximately 9% reported using agreed-upon clinical criteria to diagnose anaphylaxis; 42% reported administering epinephrine in the ED for most anaphylaxis episodes; and <50% provided patients with a prescription for an epinephrine auto-injector and/or an allergist referral on discharge. Most provided some written materials, and follow-up with a primary care clinician was recommended.CONCLUSIONS:This is the first cross-sectional survey to provide “real-world” data showing that practice in US EDs is discordant with current guideline recommendations for the diagnosis, treatment, and follow-up of patients with anaphylaxis. The primary gaps are low (or no) utilization of standard criteria for defining anaphylaxis and inconsistent use of epinephrine. Prospective research is recommended.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating the management of anaphylaxis in US emergency departments: Guidelines vs. practice

Russell

Farrar

Nowak

et al. 2013

World Journal of Emergency Medicine

View full text Add to dashboard Cite

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“…The clinical data associated to the reports have been evaluated according to NIAID/FAAN criteria [6] and the case definition of Brighton Collaboration [10,11]. We have assigned each case to one of three levels of decreasing probability using a clinical check-list based on recommendations of the Brighton Collaboration, thus obtaining two groups of patients: one group (anaphylaxis) with high, moderate and low probability of anaphylaxis and the other group (severe allergic reactions) that did not fulfill the criteria of anaphylaxis.…”

Section: Identification Of Casesmentioning

confidence: 99%

“…The wide differences in the estimated incidences and prevalences of anaphylaxis are the direct result of the absence, until recently, of a universal consensus on the definition of anaphylaxis and the different source of collected data. For this reason in 2005 the National Institute of Allergy and Infectious Disease (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) developed a very useful preliminary definition, based on diagnostic criteria [6]. The symposium defined anaphylaxis as: "a serious allergic reaction that is rapid in onset and may cause death".…”

mentioning

confidence: 99%

Incidence of food anaphylaxis in Piemonte region (Italy): data from registry of Center for Severe Allergic Reactions

et al. 2013

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There are wide differences in estimated incidence and prevalence of anaphylaxis because of the absence, until recently, of a universal consensus on the definition of anaphylaxis and the different source of collected data. We aimed to estimate the incidence of food anaphylaxis based on the database of Piemonte Region (Italy) Reference Center for Severe Allergic Reactions. All cases of severe food allergic reactions reported in 2010 were studied. Clinical data associated to the reports were evaluated according to National Institute of Allergy and Infectious Disease and Food Allergy and Anaphylaxis Network diagnostic criteria of anaphylaxis. 75 % of the 778 cases were classified as food anaphylaxis (incidence of 13/100,000 personyears, ranging from 9.9 in adults to 29/100,000 person-years in children). Nuts were the most frequent foods causing anaphylaxis. Milk and eggs were responsible for anaphylaxis more often in children, while peach, vegetables and crustaceans were in adults. Cardiovascular symptoms were more frequent in adults. Gastrointestinal involvement was more frequent in children. A high prevalence of respiratory allergic comorbidities was observed. Food is an important cause of anaphylaxis, particularly in subjects with respiratory allergic comorbidities. Children and adults differ in triggers and clinical presentation of anaphylaxis.Keywords: Anaphylaxis, Food allergy, Epidemiology, Allergy Introduction Population-based studies estimate the incidence of anaphylaxis in western countries to be in the range of 4-50 per 100,000 person-years [1, 2], with a true lifetime prevalence in the range of 0.05-2 % [3]. Foods are reported to be the most important trigger of anaphylaxis, being responsible for 33.2-56 % of all anaphylaxis cases [4]. The other two principal triggers of anaphylaxis are insect stings and drugs [1,5]. The relative contribution of each of these triggers to anaphylaxis may differ according to the study design, study population, or geographic area. The wide differences in the estimated incidences and prevalences of anaphylaxis are the direct result of the absence, until recently, of a universal consensus on the definition of anaphylaxis and the different source of collected data. For this reason in 2005 the National Institute of Allergy and Infectious Disease (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) developed a very useful preliminary definition, based on diagnostic criteria [6]. The symposium defined anaphylaxis as: "a serious allergic reaction that is rapid in onset and may cause death". Clinically, involvement of at least two organs (skin or mucosal tissue, cardiovascular apparatus, breathing apparatus, gastrointestinal tract) is required, or a sudden reduced blood pressure along with a temporal relationship (generally minutes) to a potential causative agent. A problematic issue with this definition, which may explain the under-reporting or misreporting of anaphylaxis cases, is the failure to agree among health care providers on the severity threshold for classi...

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“…Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death [1]. Anaphylaxis is highly likely when any one of the following three criteria is fulfilled:…”

Section: Introductionmentioning

confidence: 99%

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Int J Aller Medications

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Second Symposium on the Definition and Management of Anaphylaxis: Summary Report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium

Cited by 975 publications

References 43 publications

Evaluating the management of anaphylaxis in US emergency departments: Guidelines vs. practice

Evaluating the management of anaphylaxis in US emergency departments: Guidelines vs. practice

Incidence of food anaphylaxis in Piemonte region (Italy): data from registry of Center for Severe Allergic Reactions

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