APEARTD

Conclusions Anaphylaxis is a sudden, severe and potentially life-threatening allergic reaction. To minimise associated mortality and morbidity, rapid recognition of signs and symptoms of anaphylaxis is essential. Timely treatment should focus on the early administration of adrenaline. Where possible, patients with anaphylaxis should initiate treatment themselves during an exacerbation of the illness. Emergency staff should be aware of their responsibilities to provide appropriate information to patients to aid self-management of the condition. Acronyms ABCDE:  airway, breathing, circulation, disability and exposure ACE:  angiotensin-converting enzyme AVPU:  alert, verbal commands, pain, unresponsive DH:  Department of Health HIV:  human immunodeficiency virus IgE:  immunoglobulin E RCUK:  Resuscitation Council (UK) NICE:  National Institute for Health and Care Excellence Glossary Anaphylaxis:  an acute allergic reaction to an antigen, such as a bee sting, t

Recognition of signs and symptoms To treat the condition successfully, it is essential to recognise the signs and symptoms of anaphylaxis. Systemic signs and symptoms that largely distinguish the patient with anaphylaxis from those with severe allergy have already been described. Training programmes that educate the lay person, including parents and extended family, partners, teachers, nursery workers and patients themselves, have been found to be successful in imparting knowledge concerning recognition and treatment ( Litarowsky  et al  2004 ,  Morris  et al  2011 ). Potential reasons for non-recognition and treatment of anaphylaxis may include ( Brown 2006 ,  RCUK 2008 ,  Jevon 2010 ,  Arnold and Williams 2011 ,  Dunbar and Luyt 2011 ,  Spickett and Stroud 2011 ,  Caton and Flynn 2013 ): Failure of patients to appreciate the gravity of their symptoms until it is too late to auto-inject. Not having a written action plan for use in an emergency. Mistaken diagnosis. Failure of