Guidelines for the management of anaphylaxis in children and adolescents

Anaphylaxis is a severe life-threatening generalized or systemic hypersensitivity reaction. All doctors and other medical staff should be familiar with the treatment of anaphylaxis. Food, insect bites and drugs and are principal agents responsible for anaphylaxis in children and adolescents. In the absence of treatment, the reaction may rapidly progress with severe manifestations including fatal outcome. Intramuscular adrenaline is first-line therapy for anaphylaxis. Additional measures, such as removing the trigger, call for help, the correct position of the child or adolescent, high-flow oxygen, volume support, bronchodilator and adrenaline inhalations, systemic antihistamine and glucocorticoid, are supplementary to adrenaline. At discharge from hospital it is necessary to assess the risk of future anaphylaxis to determine the individualized management plan in case of anaphylaxis and to prescribe adrenaline auto-injector. Training of the child, parents and others who take care of the child, on when and how to use the self-injectable devices of adrenaline is necessary. Allergy assessment at an allergists office is obligatory in all children with a history of anaphylaxis in order to determine the cause of anaphylaxis, to provide detailed instructions on allergen avoidance and, if possible, to start with specific immunotherapy.