Anaphylaxis in an emergency department: Epidemiology, clinical features and management

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Published Sep 29, 2017
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Vol. 95 No. 1 (2017): Issue Jan 2017

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Hanen Ghazali
Mouna Gammoudi
Anware Yahmadi
Ghezela Chaaebeni
Ahmed Souyah
Sami Souissi

Abstract

 Introduction: Studies report that anaphylaxis was under-diagnosed in emergency department (ED) and emergency management was often in disagreement with international recommendations.

Aim of the study: The aim of this study was to describe the epidemiology, clinical features, management and outcome of patients with anaphylaxis presenting to an ED.

Methods: Prospective, observational study over four years (June 2010 to May 2014). Inclusion criteria: patients (> 14 years of age) presenting consecutively to the ED with the diagnosis of anaphylaxis. Collection of epidemiological, clinical and therapeutic parameters

Results: During the study, 239 patients were enrolled. Mean age = 40±15 years. Sex-ratio=0.8.  History of anaphylaxis was reported in 40% of cases. Clinical features n (%): cutaneous features 229 (96), cardiovascular features 124 (52), respiratory features 127 (53), gastrointestinal features 48 (20) and neurologic features 4 (10). Most common allergens: drugs 62%, food 24% and insects 4%. No causes were apparent in 8% of cases. An anaphylactic shock was recorded in 73 patients (31%). Adrenaline was used in 83%of patients, intravenously in 31%.  Corticosteroids and histamine H1 antagonist were prescribed in 98 and 51% respectively. Biphasic reactions were reported in three patients. There was no death cases registered.

Conclusion: Our results showed that the prevalence of anaphylaxis was low.This demonstrates that anaphylaxis is a situation which remains underestimated. It is therefore imperative to conduct prospective multicenter studies in emergency services for better determination of its impact and its risk factors.

Keywords:

Anaphylaxis, Epinephrine, Immediate hypersensitivity, emergency department

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