Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project

Abstract

Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives.

Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis

“…Grade 5, Fatal reaction. The optimum minimum panel of NMBA (the NAP6 Panel) was defined to establish a safe NMBA for routine and emergency anaesthesia, constituting the suspected trigger plus suxamethonium, rocuronium and atracurium (or cis‐atracurium) …”

“…Adherence was generally poor, in contrast to high self‐reported adherence in the NAP6 Baseline Survey (Figure ) . For AAGBI guidance 32% and BSACI guidance 17% were fully adherent; most non‐adherence occurred through failing to test for potential culprits, deficiencies in communication with patients or healthcare staff.…”

“…UK Allergy Specialist Peri‐operative Anaphylaxis Clinics are few and distributed unequally . The 2016 NAP6 baseline survey identified the self‐reported clinical activity and perceived adherence to national guidance from the Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the British Society for Allergy and Clinical Immunology (BSACI) on investigation of anaphylaxis during general anaesthesia and the National Institute for Clinical Excellence (NICE) CG183 “Drug allergy: diagnosis and management of drug allergy in adults, children and young people” …”

Developments in the field of allergy in 2017 through the eyes of Clinical and Experimental Allergy

“…28 A total of 266 cases met the inclusion criteria, three-quarters with an identified trigger. 28 A total of 266 cases met the inclusion criteria, three-quarters with an identified trigger.…”

The national perioperative anaphylaxis audit project

“…The National Audit Project 6 perioperative anaphylaxis final report was launched on 14 May 2018 . The project has collected comprehensive information on perioperative anaphylactic events to facilitate collaboration between anaesthetics and allergy to improve patient care.…”