The prevention and management of anaphylaxis in children

Abstract

The severity of allergic reactions covers a spectrum, from mild (e.g. facial urticaria) to severe (severe dyspnoea and/or hypotension). Anaphylaxis represents an extreme end of this spectrum and has unpredictable and life-threatening consequences. In the adult population it is most often caused by drugs, food and hymenoptera venom, but in young children food and drugs are usually responsible. The incidence has increased over recent years, a trend seen in all allergic disease. Treatment of acute anaphylaxis is described. Prevention of further episodes is vital and is most effectively achieved by early referral to a specialist allergy clinic. The cause of anaphylaxis may then be determined, detailed advice given on allergen avoidance and treatment of further reactions, with training of carer/school in allergen avoidance and self-administration of emergency medication. This approach has been shown to reduce the number and severity of subsequent allergic reactions and provides a model of good practice applicable to all causes of anaphylaxis.