• Alain Larcan and Denise Anne Moneret-Vautrin.
• Faculté de médecine de Nancy, réseau allergo-vigilance 15, rue du Bois de la Champelle, 54500 Vandœuvre-Lès-Nancy, France.
• Presse Med. 2013 Jun 1;42(6 Pt 1):922-9.

UnlabelledAnaphylaxis is the most serious form of the IgE-dependent food allergy, with lethal risk. The incidence is sharply rising.ObjectiveAnalysis of the actual management of anaphylaxis, searching for the appropriateness with the International Guidelines highlighting the absolute need of epinephrine, and further suggestions for the improvement of treatment.MethodA general review of international studies stemming from Emergency Departments (ED), Paediatric, Resuscitation, Cardiologic or Allergy Departments over 1999-2012, as well of International Guidelines about the management of anaphylaxis.ResultsThe self-injectable epinephrine by the patients is under-used. Treatment by epinephrine in ED has a low concordance with recommended guidelines. The discharge prescriptions of self-injectable epinephrine and referral to allergy testing are quite insufficient.ConclusionThe actual management of anaphylaxis does not fit with the International Guidelines. Anaphylaxis treatment protocols according to the international criteria should be applied in ED. Risk reduction strategies cannot rely only on the self-administration of epinephrine by the patient and should put forward a better efficiency of all first-aid care providers. A targeted educational intervention should be developed to improve the care of emergency medical services providers. They should have self-injectable-epinephrine available and should be coached to use it properly.Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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