In this issue, we collaborated with CJEM team to create a visual abstract on the article “Factors influencing emergency department observation time following anaphylaxis: a systematic review”.1
Anaphylaxis is a condition that warrants an observation period after symptom resolution to detect rare, but life-threatening, delayed complication. Simard et al. worked to identify factors that may influence the need for longer observation in the emergency department. Forty-nine studies met inclusion criteria, and identified that the biphasic reaction is the only adverse effect that warranted prolonged observation.
The authors were not able to provide specific guidance on the observation period needed to manage anaphylaxis safely. However, the authors identified five risk factors associated with biphasic reactions: time to first epinephrine, number of epinephrine doses, symptom severity, history of anaphylaxis, and unknown trigger. These identified factors can now aid the development of an early discharge screening tool for Emergency care providers. In the meantime, clinicians should use their best estimation of biphasic anaphylaxis on assessment, as well as patient reliability and proximity to medical care, as no single risk factor can predict their outcome.
This post was copyedited by Samuel Wilson (@samwilson_95)
- 1.Simard D, Bouchard V, Plourde A, et al. Factors influencing emergency department observation time following anaphylaxis: a systematic review. Can J Emerg Med. Published online April 12, 2021:480-493. doi:10.1007/s43678-021-00112-z