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Anaphylaxis Care in the ED

Anaphylaxis Care in the ED

Guidelines and updated emergency medicine (EM) practice parameters have been issued for the management of anaphylaxis in the ED, but research indicates that significant knowledge and practice gaps persist. In July 2011, a round-table meeting called Anaphylaxis in Emergency Medicine was conducted, consisting of a multidisciplinary group of experts who reviewed the current guidelines and how they are applied in different emergency medical settings in the United States. The experts agreed that the root cause for many treatment gaps for anaphylaxis was the lack of a practical definition of anaphylaxis as it relates to EM. “There is concern that EM professionals may not be using current guidelines and practice parameters fully,” explains Richard Nowak, MD, who chaired the Anaphylaxis in Emergency Medicine roundtable panel. “This results from not having a consensus in published guidelines on the definition of anaphylaxis. Another key factor is that there are differences in signs and symptoms of how anaphylaxis presents in EDs, compared with those occurring in allergists’ offices.” A Practical Definition of Anaphylaxis In 2013, Dr. Nowak and colleagues published an article in the Journal of Emergency Medicine that customized anaphylaxis guidelines for EM. Articulating a simple standardized practical definition of anaphylaxis and describing characteristic findings in the clinical criteria for identifying it were an important emphasis (Table 1). The working definition was modified, building upon definitions suggested by other groups, so that it is clinically more relevant to emergency providers. Dr. Nowak and colleagues also developed consensus statements that encouraged practical application of guidelines when managing anaphylaxis (Table 2). “These statements expand the discussion on how to diagnose and manage anaphylaxis in...
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