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\begin{document}

\title{Real World Management of Anaphylaxis Versus the NICE Guidelines}



\author[1]{Iman Nasr}%
\author[1]{Asmaa   Mahdi}%
\author[1]{Humaid Al Wahshi}%
\author[2]{Ikram Nasr}%
\author[1]{Saad Al Juma}%
\author[3]{Latifa Alshekaili}%
\author[4]{Ibrahim Al Zakwani}%
\author[1]{Issa Al Salmi}%
\affil[1]{The Royal Hospital}%
\affil[2]{Guy's and St Thomas' Hospitals NHS Trust}%
\affil[3]{King Faisal Hospital and Research Center}%
\affil[4]{Sultan Qaboos University College of Medicine and Health Science}%


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  \date{May 26, 2024}


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\begin{abstract}
Objectives: Anaphylaxis is an acute, life-threatening allergic reaction
involving multiple systems caused by the sudden release of mediators
from mast cells. This study aims to assess the current practice of
emergency management of adults and children diagnosed with anaphylaxis
at the Royal Hospital, against the recommendations of the National
Institute for Health and Clinical Excellence (NICE) guidelines. Methods:
This is an observational study of all anaphylaxis cases which took place
at the emergency department (ED) during a 5-year period. Results: Of 100
patients with a preliminary diagnosis of anaphylaxis, 49\% were
true-anaphylaxis cases based on the WAO definition. All the 49-patients
with true-anaphylaxis received adrenaline intramuscularly at ED. 24
(48.9\%) of them were referred to an immunologist: 8/24 (33.3\%) were
adults and 16/24 (66.6\%) were children. 16-children were admitted, seen
by an immunologist and received an adrenaline autoinjector when
indicated. 25 of the 33 adult patients (75.7\%) were discharged from the
ED with no onward referral to a specialist. None of the adult patients
received an adrenaline autoinjector prior to discharge from ED and no
one had a tryptase level checked. Conclusion: The paediatric emergency
department fulfilled all the criteria for anaphylaxis management in
accordance with NICE guidelines except for measuring serum tryptase
where appropriate. By contrast, the adult patients were discharged from
ED without an adrenaline autoinjector as an interim measure until seen
by an allergist or immunologist. Therefore, education is the best
strategy to improve the management of this severe and possible fatal
condition.%
\end{abstract}%



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\textbf{Hosted file}

\verb`Real World Management of Anaphylaxis Versus the NICE Guidelines Manuscripts with tables and figures.docx`  available at \url{https://authorea.com/users/726286/articles/708884-real-world-management-of-anaphylaxis-versus-the-nice-guidelines}

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