BMJ 1995;311:731-733 (16 September)

Education and debate

Fortnightly Review: Treatment of acute anaphylaxis

Malcolm Fisher, head a

a Intensive Therapy Unit, Royal North Shore Hospital, St Leonards, New South Wales 2065, Australia


Summary points

  • Adrenaline is the treatment of choice for clinical anaphylaxis

  • Volume replacement is indicated in anaphylactic cardiovascular collapse

  • Follow up, diagnosis, and detailed communications are essential in preventing second reactions


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Relevant Articles

Treatment of acute anaphylaxis
L C Luke
BMJ 1995 311: 1434. [Extract] [Full Text]

Remove the patient from contact with the allergen
Glenis K Scadding
BMJ 1995 311: 1434. [Extract] [Full Text]

Benign allergic reactions should not be treated with adrenaline
Jonathan O'B Hourihane and John O Warner
BMJ 1995 311: 1434. [Extract] [Full Text]

Avoid subcutaneous or intramuscular adrenaline
R Alexander, J Pappachan, G B Smith, and B L Taylor
BMJ 1995 311: 1434-1435. [Extract] [Full Text]

Expressing the dose of adrenaline in milligrams is easier
Stewart Campbell
BMJ 1995 311: 1435. [Extract] [Full Text]

Treatment takes precedence over monitoring
John Clear, Michael Yeoh, and Stephen Cockroft
BMJ 1995 311: 1435. [Extract] [Full Text]

Investigations help to confirm diagnosis
S M Robinson
BMJ 1995 311: 1435. [Extract] [Full Text]

Chart helps with calculation of dose of adrenaline for children
James Stuart
BMJ 1995 311: 1435-1436. [Extract] [Full Text]

Teachers need to know the basics too
Fiona Finlay and Neil Simpson
BMJ 1995 311: 1436. [Extract] [Full Text]

This article has been cited by other articles:

  • Currie, M, Kerridge, R K, Bacon, A K, Williamson, J A (2005). Crisis management during anaesthesia: anaphylaxis and allergy. Qual Saf Health Care 14: e19-e19 [Abstract] [Full text]  
  • Ryder, S.-A., Waldmann, C. (2004). Anaphylaxis. Contin Educ Anaesth Crit Care Pain 4: 111-113 [Abstract] [Full text]  
  • Breslin, D. S., McBrien, M. E., Hepner, D. L. (2004). Management of Severe Anaphylactic Reactions Should Include Administration of Alpha Adrenergic Agonists * Response. Anesth. Analg. 98: 1499-1500 [Full text]  
  • McLean-Tooke, A. P C, Bethune, C. A, Fay, A. C, Spickett, G. P (2003). Adrenaline in the treatment of anaphylaxis: what is the evidence?. BMJ 327: 1332-1335 [Full text]  
  • Stefanutto, T. B., Halbach, V. (2003). Bronchospasm Precipitated by Ethanol Injection in Arteriovenous Malformation. Am. J. Neuroradiol. 24: 2050-2051 [Abstract] [Full text]  
  • Brown, A. F T (2001). Anaphylaxis: quintessence, quarrels, and quandaries. Emerg. Med. J. 18: 328-328 [Full text]  
  • Fenwick, M J, Muwanga, C L (2000). Anaphylaxis and monoamine oxidase inhibitors--the use of adrenaline. Emerg. Med. J. 17: 143-144 [Abstract] [Full text]  
  • Fisher, M. (1996). Treatment of acute anaphylaxis. BMJ 312: 637c-638 [Full text]  
  • Luke, L C (1995). Treatment of acute anaphylaxis. BMJ 311: 1434-1434 [Full text]  
  • Campbell, S. (1995). Expressing the dose of adrenaline in milligrams is easier. BMJ 311: 1435-1435 [Full text]  
  • Finlay, F., Simpson, N. (1995). Teachers need to know the basics too. BMJ 311: 1436-1436 [Full text]  
  • Scadding, G. K (1995). Remove the patient from contact with the allergen. BMJ 311: 1434a-1434 [Full text]  
  • Hourihane, J. O'B, Warner, J. O (1995). Benign allergic reactions should not be treated with adrenaline. BMJ 311: 1434b-1434 [Full text]  
  • Alexander, R, Pappachan, J, Smith, G B, Taylor, B L (1995). Avoid subcutaneous or intramuscular adrenaline. BMJ 311: 1434c-1435 [Full text]  
  • Clear, J., Yeoh, M., Cockroft, S. (1995). Treatment takes precedence over monitoring. BMJ 311: 1435a-1435 [Full text]  
  • Robinson, S M (1995). Investigations help to confirm diagnosis. BMJ 311: 1435b-1435 [Full text]  
  • Stuart, J. (1995). Chart helps with calculation of dose of adrenaline for children. BMJ 311: 1435c-1436 [Full text]  



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