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Anaphylaxis is a potentially life-threatening allergic reaction that can present in primary care. General practitioners play a critical role in identifying patients at risk, managing emergencies, and prescribing adrenaline auto-injectors to mitigate future risks. This guide provides a structured approach to risk assessment, prescribing, and patient education, ensuring safe and effective management in line with RCGP curriculum competencies.
Key Points for GPs: Adrenaline Auto-Injectors (AAIs)
AAIs are the first-line emergency treatment for anaphylaxis.
Risk assessment is guided by clinical history, not solely allergy testing.
Prescribe two devices for patients at significant risk and refer to an allergy specialist for further evaluation.
Ensure patients and carers receive training on AAI administration and have a written anaphylaxis action plan.
STEP 1- when to consider
| Indication | Examples / Notes |
|---|---|
| Previous anaphylaxis of unknown cause | Idiopathic anaphylaxis |
| Anaphylaxis with unavoidable trigger | Bee/wasp stings, common food allergens (e.g., nuts, shellfish) |
| Allergy to high-risk allergens + additional risk factors | Peanuts, tree nuts + asthma, poorly controlled asthma, adolescence (higher risk group) |
| Reaction to trace amounts of allergen | Highly sensitive individuals |
| Co-morbidities increasing risk | Asthma, mastocytosis, ↑ baseline tryptase |
| Post-emergency treatment for anaphylaxis | After hospital/ED discharge for anaphylaxis |
| High risk of exposure to known allergens... |
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