Full definition of anaphylaxis

Its been a interesting phenomenon taht the definition of anaphylaxis was quite unclear until the last few years. Here's a good reminder in case you get quizzed by someone! Now if only we could get see the end of "steroids or not" debate.

What's not in conjecture is the primary treatment for the below >>> ADRENALINE

Thanks to JournalWatch for this table:

 Full Definition of Anaphylaxis for Emergency Health Professionals^1–3

Part 1. Working Definition: Anaphylaxis is a serious reaction that is rapid in onset and may cause death. It is usually due to an allergic reaction but can also be non-allergic.

Part 2. Clinical criteria to diagnose an acute anaphylactic episode: Anaphylaxis is highly likely when any one of the following 3 criteria is fulfilled:

1. Acute onset (minutes to several hours) of an illness involving the skin, mucosal tissue, or both (e.g., generalized hives, pruritus or flushing, swollen lips-tongue-uvula) AND AT LEAST ONE OF THE FOLLOWING:

a. Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)

b. Reduced blood pressure (BP) or associated symptoms of end-organ dysfunction (e.g., hypotonia, syncope)

OR

2. Two or more of the following that occur rapidly (minutes to several hours) after exposure to a likely allergen for the patient:

a. Involvement of the skin-mucosal tissue (e.g., generalized hives, itch-flush, swollen lips-tongue-uvula)

b. Respiratory compromise (e.g., dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)

c. Reduced BP or associated symptoms of end-organ dysfunction (e.g., hypotonia, syncope)

d. Persistent gastrointestinal symptoms (e.g., crampy, abdominal pain, vomiting)

OR

3. Reduced BP occurring rapidly (minutes to several hours) after exposure to known allergen for the patient

a. Infants and children: low systolic BP (age specific) or > 30% decrease in systolic BP

b. Adults: systolic BP < 90 mm Hg or > 30% decrease from baseline

References:

1. Simons FE, Ardusso LR, Bilo MB, et al. World Allergy Organization guidelines for the assessment and management of anaphylaxis. J Allergy Clin Immunol 2011;127:587–93.
2. Lieberman P, Nicklas RA, Oppenheimer J, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol 2010;126:477–80.
3. Boyce JA, Assa'ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 2010;126(Suppl 1):S1–58.