ASCIA guidelines for prescribing an adrenaline autoinjector

Published in NPS RADAR

Date published: About this date

Clinical content may change after this date. This information is not intended as a substitute for medical advice from a qualified health professional. Health professionals should rely on their own expertise and enquiries when providing medical advice or treatment.
This page contains additional content relating to the article Adrenaline autoinjector (Anapen) for acute allergic anaphylaxis, published 1 August 2010.

 

ASCIA* guidelines for prescribing an adrenaline autoinjector

ALWAYS RECOMMENDED

History of anaphylaxis (if patient is considered to be at continuing risk)

Anaphylaxis

A rapidly-evolving, generalised multisystem allergic reaction.

Characterised by one or more symptoms or signs of respiratory and/or cardiovascular involvement and involvement of other systems such as the skin and/or gastrointestinal tract.

Respiratory symptoms

  • Difficult/noisy breathing
  • Swelling of tongue
  • Swelling/tightness in throat
  • Difficulty talking and/or hoarse voice
  • Wheeze or persistent cough

Cardiovascular symptoms

  • Loss of consciousness
  • Collapse
  • Pale and floppy (in young children)
  • Hypotension

SOMETIMES RECOMMENDED

History of a generalised allergic reaction AND one or more risk factors

Generalised allergic reaction

Characterised by one or more symptoms or signs of skin and/or gastrointestinal tract involvement without respiratory and/or cardiovascular involvement.

Skin symptoms

  • Generalised pruritus
  • Urticaria/angioedema
  • Erythema

Gastrointestinal symptoms

  • Abdominal pain
  • Vomiting
  • Loose stools

Risk factors

  • Asthma (current or past history)
  • Age (children over 5 years, adolescents and young adults)
  • Specific allergic triggers:
    — peanut/nut allergy
    — stinging insect allergy in adults (bees, wasps, jumper ants)
  • Comorbidity (e.g. ischaemic heart disease)
  • Geographical remoteness from emergency medical care

NOT NORMALLY RECOMMENDED
  • Asthma with no history of anaphylaxis or generalised allergic reactions
  • Elevated specific IgE only (positive RAST and/or skin test) without a history of clinical reactions
  • Family (rather than personal) history of anaphylaxis or allergy
  • Local reactions to insect stings – in adults and children
  • Generalised skin rash (only) to bee or wasp stings – in children
  • Resolved food allergy

*Abbreviated from ASCIA (the Australasian Society of Clinical Immunology and Allergy) guidelines for adrenaline autoinjector prescription