Anaphylaxis in the emergency room

Abstract

Introduction: anaphylaxis is considered a serious systemic reaction which can be fa­tal and should be promptly identified and treated by the patient, people who witness the episode before arrival at the health unit (pre-hospital care) and by health professionals in the hospital environment. Objective: the objective of this work is to present an update on the subject, observing the conducts to be taken in each of the phases of the process. Data source: review on platforms of Medline, PubMed and SciELO articles with no date limit, searching articles with the keywords ‘anaphylaxis’, ‘emergency’ and ‘epinephri­ne’ in Portuguese and English. Data synthesis: the first line and pre-hospital therapy is still adrenaline administered intramuscularly, the only medication capable of preventing the progression of life-threatening respiratory and cardiovascular symptoms. Other mea­sures should, however, be taken in the presence of the progression of the episode, since in some cases an immediate response to this medication is not observed, requiring greater life support care. A relapse may be observed in some patients, hence the need for an ob­servation time after initial control. Conclusions: research has revealed that adrenaline is still less commonly used by health professionals when compared to antihistamines and corticosteroids. The diagnosis should be rapid and promptly instituted. Patients who did not receive adrenaline early had greater morbidity and required longer periods of hospita­lization for the control of the clinical condition, which may eventually evolve to death. The health professional should be aware to the signs and symptoms of anaphylaxis, improving their diagnostic ability.