This course is designed for healthcare professional who are responsible for both the diagnosis and management of a patient with anaphylaxis without intravenous access for their patient.

This course has been accredited by ACRRM for a total of 3 hours of CPD.

Educational Activity: 2 hours

Outcome Measurement: 0.5 hours

Performance Review: 0.5 hour

Event ID: 

Learning Objectives

The learning objectives for this course are:

1. To be able to identify potential causes and triggers of anaphylaxis and describe how it is mediated.
2. To be able to describe the pathophysiological processes of anaphylaxis.
3. To be able to determine the difference between anaphylaxis, a simple allergic reaction, and the relevant differential diagnoses.
4. To be able to describe the appropriate management for a patient experiencing anaphylaxis including intravenous management techniques.
5. To be able to apply this knowledge of the processes and management of anaphylaxis to clinical practice. 

Module 1 – Foundations

In Module 1 we will discuss the foundations of anaphylaxis including:

• What is anaphylaxis
• How is anaphylaxis triggered
• How is anaphylaxis mediated
• Summation anaphylaxis
• The co-factors and co-morbidities that are important in anaphylaxis and
• The Scales of Anaphylaxis

Module 2 – Pathophysiology

In Module 2 we will discuss the pathophysiology of anaphylaxis including:

• The mediators of inflammation
• The four pathological processes that occur in anaphylaxis
• How these four processes then cumulatively present in the skin, cardiovascular, respiratory, gastrointestinal and neurological systems
• The causes of death in anaphylaxis and
• How the pathophysiology relates to the ASCIA definition of anaphylaxis

Module 3 – Diagnosis

In Module 3 we will discuss how to diagnose anaphylaxis and differentiate it from a simple allergic reaction and our other differential diagnoses. We shall consider:

• The principles of making a diagnosis of anaphylaxis
• The theme and variations of anaphylaxis presentations
• Anaphylaxis with no skin manifestations
• How to effectively use my Anaphylaxis Management form in the diagnosis of anaphylaxis.
• Red flag signs and symptoms
• The Zebra principle
• Abdominal pain and vomiting in anaphylaxis and the differential diagnoses for it .
• Diagnosing anaphylaxis in infants and the special considerations here.
• Signs of mild to moderate allergy
• Anaphylaxis verses asthma
• Anaphylaxis verses vasovagal
• The other differential diagnoses of anaphylaxis
• Diagnosing nausea and vomiting after administration of radiocontrast

Module 4 – Management

In Module 4 we will discuss:

• Some general points on the management of anaphylaxis
• The aims of management of anaphylaxis
• The role (or not) of antihistamines in anaphylaxis
• The 7 steps of the Australian Prescriber Anaphylaxis Management chart
• Importance of laying your patient down and positioning them
• Intramuscular adrenaline 
• Adrenaline:
  • Why we give it
  • Mechanism of action and
  • Where to give it
• Managing Asthma v Anaphylaxis
• The dynamic nature of the Scales of Anaphylaxis
• Dosages of adrenaline
• The timing of administration of adrenaline
• EpiPen and Anapen administration
• Jext and neffy adrenaline devices
• Anaphylaxis and pregnancy
• Special considerations for children in managing anaphylaxis
• Equipment for managing anaphylaxis
• Supportive management which includes:
  • Oxygen administration 
• Additional Measures which include 
  • Nebulised adrenaline protocol  
  • The role of salbutamol 
  • Nebulised salbutamol with oxygen delivery 
• The biphasic response
• Observation of the patient and points to consider
• The role of corticosteroids
• Follow-up treatment which includes:
  • Referral to an allergy specialist
  • Providing an autoinjector
• Discussion of antihistamines
• Signs of overtreatment
• Airway management
• Fatal Anaphylaxis
• Managing a cardiac arrest following anaphylaxis

Module 5 – Case Studies

There are 19 case studies reviewed in Module 5 which follow the following format:

• Discussion of the patient’s demographics
• Review and categorisation of the signs and symptoms
• Discussion of the progress and management of the patients which is presented in a table
• Review of the pathophysiology
• Discussion of the relevant points of the case
• In some cases, where relevant, discussion of the debriefing that subsequently occurred.