Signs of anaphylaxis

In severe anaphylaxis under anaesthesia, which of the following is MOST COMMONLY the first to be detected?

a) Flushing of the skin

b) Facial oedema

c) Desaturation

d) Difficulty in ventilating

e) Decrease in arterial pressure

Answer: e

Explanation

Decrease in arterial pressure is the first sign to be detected in 28% of cases, with

difficulty in ventilating at 26%, flushing at 21%, desaturation at 3% and swelling

at <3%.

Reference

Harper NJ, Dixon T, Dugué P, et al. Suspected anaphylactic reactions associated with

anaesthesia. Anaesthesia 2009; 64(7): 199–211. Online at www.aagbi.org/publications/

guidelines/docs/anaphylaxis_2009.pdf (Accessed 30 October 2009)