STANDARDS
Anaphylaxis demands prompt action Associate Professor Amanda Walker, Clinical Director at the Australian Commission on Safety and Quality in Health Care, explains why clinicians and health services need to be consistent in managing this potentially fatal condition.
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o observe someone experience anaphylaxis can be confronting. As clinicians know, it is a condition that demands immediate action and a prompt response could save someone’s life. Recognising anaphylaxis as early as possible is crucial, as reactions can escalate quickly from the initial signs. Each year more than 11,500 Australians present to public hospital emergency departments with anaphylaxis, and this figure is rising. It increased 51% in the five years to 2019–20.1 It is a sobering fact that up to 20 Australians die from anaphylaxis every year, and we have one of the highest documented rates of hospital anaphylaxis admissions in the developed world.2 While fatalities are not common, they are often preventable. Given this context, it is no surprise the release of the first national standard of care for patients with anaphylaxis has been welcomed across the healthcare sector. The Australian Commission on Safety and Quality in Health Care (the Commission) released the Acute Anaphylaxis Clinical Care Standard in November following extensive public consultation. Anaphylaxis occurs when the immune system overreacts to an allergy trigger, or allergen. Common triggers are foods such as nuts, milk, fish, shellfish and eggs, insect venoms such as wasp and bee stings, and some medicines. Up to 10% of infants and 2% of adults have food allergies.3 The burden of managing allergies to prevent anaphylaxis affects many in our community. Currently around one in five Australians, or four million people, live with allergies4, 38
HOSPITAL + HEALTHCARE
including many allergies that could trigger an anaphylactic reaction. The condition can be indiscriminate and affect children and young people in the prime of their lives. Anaphylaxis is a condition that requires management throughout the patient journey — from emergency care and acute settings to the community with general practice and specialist care. The standard describes the care that people can expect when they experience anaphylaxis and recommends priority areas for clinicians who are managing treatment across this spectrum.
Addressing gaps in patient care
Actions in the Acute Anaphylaxis Clinical Care Standard address particular gaps that SUMMER 2022
have been identified in patient care, to help ensure consistent, safe care for all patients presenting with anaphylaxis. These include ensuring timely treatment with adrenaline and strengthening the process for handover of care along the patient journey. Based on guidelines from the Australasian Society of Clinical Immunology and Allergy (ASCIA), the standard comprises six evidencebased quality statements covering: • Prompt recognition of anaphylaxis • Immediate injection of intramuscular adrenaline • Correct patient positioning • Access to a personal adrenaline injector in all healthcare settings
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