Anaphylaxis

Pre-referral guidelines for primary care providers

Anaphylaxis is a potentially life threatening severe IgE-mediated allergic reaction to several possible allergens. Also see the allergy pre-referral guideline for further details.

For acute management of anaphylaxis please refer to the Royal Children's Hospital Clinical Practice Guidelines.

Diagnosis

Anaphylaxis is characterised by:

  • airway symptoms (difficult or noisy breathing, tongue swelling, throat tightness, hoarseness, wheeze or persistent cough)
  • systemic symptoms (dizziness and/or collapse, hypotension, which can present as pallor and floppiness in young children)

Practice points

  • The conditions of urticaria, angioedema, atopy, FPIES and most food allergies (including cow's milk or soy protein allergy) do not equal a diagnosis of anaphylaxis (see the allergy pre-referral guideline for further detail).
  • Acute anaphylaxis is a potentially life-threatening emergency and should be referred to a local Emergency Department for management.

Management

For acute management of anaphylaxis please refer to the Royal Children's Hospital Clinical Practice Guidelines. Acute anaphylaxis is a potentially life-threatening emergency and should be referred to a local Emergency Department for management.

Ongoing management of anaphylaxis requires avoidance of the offending trigger (if known) prior to paediatric allergist consultation. Any child with known anaphylaxis should have:

Referral pathways

  • Paediatrician
    • Skin prick testing and allergy consultations are available though Paediatrics Ballarat or the Ballarat Allergy Clinic as private services.
    • Currently the services offered in Ballarat do not include testing for drug allergies (although challenges may be offered in select circumstances) or insect allergies.
  • Dietitian
    • Following assessement by a paediatrician with an interest in allergy, a secondary referral to dietetic services may be indicated.
  • Other resources