Management of a Patient with Anaphylaxis

PROGRAM DESCRIPTION: Anaphylaxis is an acute, potentially life-threatening systemic allergic reaction that may have a wide range of clinical manifestations. The lifetime prevalence of anaphylaxis has been estimated at 1.6% to 5.1%. Medications and stinging insects are the leading triggers in adults, with foods and stinging insects the most frequently implicated triggers in children and adolescents. IgE binding and cross-linking of the high affinity IgE receptor (FcεRI) on the surface of mast cells and basophils is an important mechanism in many cases of anaphylaxis. Anaphylaxis involves additional cell types that may include neutrophils, monocytes, macrophages, and platelets.

Epinephrine is the first-line treatment for anaphylaxis. Epinephrine is the cornerstone of anaphylaxis management but continues to be underutilized. Antihistamines and/or glucocorticoids are not reliable interventions to treat anaphylaxis.

This session will work through a case-based scenario of an allergy emergency/anaphylaxis associated with allergen immunotherapy in the office. Elements of the patient’s history and physical exam findings will be used to determine the diagnosis. Treatment strategies will be discussed, with particular attention to allergy emergencies encountered in the clinical setting.

The presenters will lead the participants through the updated Anaphylaxis: A 2023 Practice Parameter Update by working through a real world scenario.

This small group session will feature interactive teaching and learning strategies. We will work though a case of an episode of anaphylaxis triggered from allergy testing. It is important that otolaryngologists offering allergy services be competent in the management of anaphylaxis. This is emphasized in the Clinical Practice Guideline: Allergen Immunotherapy with a strong recommendation that clinicians performing allergy skin testing or administering allergen immunotherapy must be able to diagnose and manage anaphylaxis.

OUTCOME OBJECTIVE 1: Recognize the signs and symptoms of anaphylaxis

OUTCOME OBJECTIVE 2: Acknowledge that epinephrine is the first line treatment for anaphylaxis

OUTCOME OBJECTIVE 3: Demonstrate competence in treating anaphylaxis

BACKGROUND STATEMENT: Management of anaphylaxis and other allergy emergencies had been identified in a comprehensive gap analysis conducted by the AAO-HNSF Education Committees in 2022 and 2023. Many members may not be aware that there has been a recent practice parameter update to anaphylaxis published.

Comprehensive Otolaryngology Track Statement :