“Although anaphylaxis management recommendations depend on practice resources and proximity to emergency services, key components for medical clinics include a highly visible anaphylaxis protocol, regular rehearsals, appropriately maintained supplies, and a treatment log to record events.[3,19]
Clinic staff should be familiar with an anaphylaxis management protocol that is tailored to their office and incorporates input from staff members across multiple disciplines. This protocol should feature flow charts for initial management of respiratory distress and hypotension/shock, and should include drug dosages, supplemental oxygen and intravenous fluid recommendations, and contact information for emergency medical services. The importance of a protocolized approach to anaphylaxis care cannot be overstated because the rapidly evolving nature of anaphylaxis does not afford the time to look up information or recall memorized algorithms. In one pediatric emergency department, implementing an anaphylaxis protocol enhanced anaphylaxis management by improving the rates of epinephrine administration and appropriate observation, and by reducing the rate of corticosteroid monotherapy.
Guidelines strongly recommend regular anaphylaxis rehearsals; however, they do not specify the content or frequency of those events, but rather defer this to the discretion of the attending physician.[3,7,19] At the least, medical professionals should be able to quickly locate and assemble necessary supplies for administration, and roles for calling emergency services and treatment logging should be established.[3,19] Readily available supplies should be maintained, and their contents and expiry dates should be regularly documented. Recommended anaphylaxis supplies are provided in the Box. Treatment logs should be readily accessible for documenting clinical events, vital signs, and medications/treatments administered.”
More on In situ simulation training for in-office anaphylaxis preparedness via BCMJ.