The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology
Top Cited Papers
- 21 June 2007
- Vol. 62 (8), 857-871
- https://doi.org/10.1111/j.1398-9995.2007.01421.x
Abstract
Anaphylaxis is a growing paediatric clinical emergency that is difficult to diagnose because a consensus definition was lacking until recently. Many European countries have no specific guidelines for anaphylaxis. This position paper prepared by the EAACI Taskforce on Anaphylaxis in Children aims to provide practical guidelines for managing anaphylaxis in childhood based on the limited evidence available. Intramuscular adrenaline is the acknowledged first‐line therapy for anaphylaxis, in hospital and in the community, and should be given as soon as the condition is recognized. Additional therapies such as volume support, nebulized bronchodilators, antihistamines or corticosteroids are supplementary to adrenaline. There are no absolute contraindications to administering adrenaline in children. Allergy assessment is mandatory in all children with a history of anaphylaxis because it is essential to identify and avoid the allergen to prevent its recurrence. A tailored anaphylaxis management plan is needed, based on an individual risk assessment, which is influenced by the child’s previous allergic reactions, other medical conditions and social circumstances. Collaborative partnerships should be established, involving school staff, healthcare professionals and patients’ organizations. Absolute indications for prescribing self‐injectable adrenaline are prior cardiorespiratory reactions, exercise‐induced anaphylaxis, idiopathic anaphylaxis and persistent asthma with food allergy. Relative indications include peanut or tree nut allergy, reactions to small quantities of a given food, food allergy in teenagers and living far away from a medical facility. The creation of national and European databases is expected to generate better‐quality data and help develop a stepwise approach for a better management of paediatric anaphylaxis.Keywords
This publication has 103 references indexed in Scilit:
- Time trends in allergic disorders in the UKThorax, 2007
- Life-threatening asthma and anaphylaxis in schools: a treatment model for school-based programsAnnals of Allergy, Asthma & Immunology, 2006
- Sublingual epinephrine tablets versus intramuscular injection of epinephrine: Dose equivalence for potential treatment of anaphylaxisJournal of Allergy and Clinical Immunology, 2006
- Biphasic anaphylactic reactionsAnnals of Allergy, Asthma & Immunology, 2005
- Parental use of EpiPen for children with food allergiesJournal of Allergy and Clinical Immunology, 2005
- Allergy testing in children: why, who, when and how?Allergy, 2003
- Emergency department anaphylaxis: A review of 142 patients in a single yearJournal of Allergy and Clinical Immunology, 2001
- School readiness for children with food allergiesAnnals of Allergy, Asthma & Immunology, 2001
- Anaphylaxis in schools and other child-care settingsJournal of Allergy and Clinical Immunology, 1998
- Plasma catecholamine levels after intraosseous epinephrine administration in a cardiac arrest modelAnnals of Emergency Medicine, 1992