Operative procedure for the monitoring of anaphylactic reactions and the prevention of recurrence

E. Savi, S. Peveri, A. Magnacavallo, M. Bisagni

Prevention of anaphylaxis depends on optimal management of patient-related risk factors, an educational programme to teach how to avoid confirmed relevant allergens. We observed in our routine practice several patients who underwent allergological evaluation months or years after the occurrence of anaphylactic reaction or a relapse. The main issues of this proposal are to identify all patients arrived to Emergency Unit with anaphylactic reactions ranging from Mueller classification grade II-IV and to refer them to an Allergy Unit with the intent to promote,within 48 hours, a diagnostic and therapeutic programme, set the anaphylactic risk for each patient and deliver Fast Jeckt (Epinephrine autoinjectors). The programme is evaluated by Quality Unit of Piacenza's AUSL that suggests two monitoring indicators: "Efficacy" of the plan is checked measuring recurrence rate in a year,"Quickness" of Allergological consultation is monitored recording time of consultation request from Emergency Unit and time of first allergological visit . We observe an increase in the number of patients referred to the Allergy Unit within 48 hours to receive a diagnostic and therapeutic programme to prevent recurrence of anaphylaxis: 6 patients in 2007 and 31 in 2010 and a decrease in the number of patients arrived after anaphylaxis sent by practitioner: 7 in 2007 and 1 in 2010 (p <0.05) All quarterly reports have reported an Efficacy less than 15% of recurrences and a Quickness more than 90%. The procedure has received an institutional accreditation by Emilia Romagna Health Agency. These observations underline the importance of an operative procedure for the monitoring of anaphylactic reactions, in order to provide an effective and immediate medical examination and also avoid the risk of recurrence.
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