Risk factors for severe/fatal anaphylaxis
Core concept
- Delay in giving adrenaline is the single modifiable factor most strongly associated with death
- Fatal reactions have a short median time from onset to arrest: drug ~5 min, venom ~15 min, food ~30 min
- Every other intervention is secondary. Antihistamines and steroids have never been shown to prevent a fatal outcome.
- Asthma is the strongest patient-level risk factor for anaphylaxis mortality, and poorly controlled asthma more so - respiratory arrest dominates food-triggered deaths
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