Anaphylactic reactions account for the most severe and often dramatic events in allergology. For the immediate treatment of anaphylaxis national and international guidelines are crucial. Following a decision of the executive committee of the German Association of Allergology and Clinical Immunology (Deutsche Gesellschaft fur Allergologie und klinische Immunologic, DGAKI) in 2003, a task force was established to write a guideline, which has already been published. The therapeutic intervention of anaphylactic reactions depends on the history (e.g. eliciting allergen, kinetics) and the clinical presentation (symptoms and severity). An algorithm for the treatment of anaphylaxis depending on severity was constructed (Fig. 1) [1]. An immediate break of contact to the culprit elicitor is the first action. Basic interventions in anaphylaxis are appropriate positioning (flat, Trendelenburg) and to place an infusion line. An anaphylaxis educational program for patients and their relatives is in the process of construction by the German Academy for Allergology and Environmental Medicine (Deutsche Gesellschaft fur Allergologie und Umweltmedizin, DAAU). In cardiovascular and pulmonary reactions, the application of oxygen is recommended. For specific medical treatment catecholamines (epinephrine, noradrenalin and dopamine), volume substitution (electrolytes, plasma expanders), antihistamines and glucocorticosteroids have proven helpful. For treatment of children specific dosages have to be regarded. In case of cardiovascular or pulmonary arrest, an immediate and appropriate resuscitation according to the recommendations of the German Medical Association has to be initiated. Every patient who has suffered from anaphylaxis has to be informed about essential rules of conduct for the prophylaxis and therapy of anaphylactic reactions. For self-medication the patient receives an emergency kit, Under consideration of contraindications, the emergency kit for self-medication includes an epinephrine autoinjector (see above), in case of expected respiratory symptoms also an epinephrine inhalator, further a glucocorticoste-roid and an H-1-histamine antagonist.     «

Anaphylactic reactions account for the most severe and often dramatic events in allergology. For the immediate treatment of anaphylaxis national and international guidelines are crucial. Following a decision of the executive committee of the German Association of Allergology and Clinical Immunology (Deutsche Gesellschaft fur Allergologie und klinische Immunologic, DGAKI) in 2003, a task force was established to write a guideline, which has already been published. The therapeutic intervention of...     »