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Introduction to NICE Guideline on Anaphylaxis (CG134)

The NICE guideline CG134 provides comprehensive recommendations for the recognition, diagnosis, and management of anaphylaxis. It emphasises the importance of administering intramuscular adrenaline as the first-line treatment, followed by appropriate monitoring and referral to specialist services for further evaluation. The guideline also highlights the need for educating patients and carers about recognising anaphylaxis and the correct use of adrenaline auto-injectors, ensuring that they are prepared to respond effectively in emergencies.

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Recommendations from NICE Guideline on Anaphylaxis (CG134)

The NICE guideline CG134 provides a detailed framework for managing anaphylaxis, starting with the prompt administration of intramuscular adrenaline, which is crucial for halting the progression of a severe allergic reaction. Following adrenaline administration, the guideline advises close monitoring of the patient to identify any potential biphasic reaction—a secondary wave of symptoms that can occur hours after the initial response.

Referral to Specialist Services

The guideline strongly recommends that all patients who experience anaphylaxis be referred to a specialist allergy service for a comprehensive assessment. This assessment helps in identifying the specific trigger of the reaction, whether it be a food item, medication, insect venom, or another allergen. Understanding the trigger is essential for creating an effective long-term management plan that minimises the risk of future episodes.

Patient Education and Emergency Preparedness

Education is a cornerstone of the guideline. Patients, along with their families or carers, should receive thorough training on recognising the early signs of anaphylaxis and understanding the importance of carrying and using adrenaline auto-injectors. The guideline suggests that this training should include practical demonstrations and opportunities for patients to practice using a trainer device. Additionally, patients should be provided with a written emergency action plan, which outlines the steps to take if anaphylaxis occurs, including when to use the auto-injector and when to seek emergency medical help.

Long-Term Management

For long-term management, the guideline recommends regular follow-up appointments to reassess the patient’s condition, update the management plan, and provide additional education if needed. These follow-ups are crucial for ensuring that patients remain confident in managing their condition and that they are equipped with the latest information and tools to prevent and respond to anaphylactic episodes.

NICE guideline CG134

This content is based on the principles outlined in the NICE Guideline on Anaphylaxis (CG134), tailored to the needs of healthcare professionals in the UK.

NICE website

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