Wilderness Medical Society Clinical Practice Guidelines on Anaphylaxis

Flavio G Gaudio, David E Johnson, Kelly DiLorenzo, Arian Anderson, Martin Musi, Tod Schimelpfenig, Drew Leemon, Caroline Blair-Smith, Jay Lemery

Wilderness Environ Med. 2022 Mar;33(1):75-91

 

Abstract

The Wilderness Medical Society convened a panel to review the literature and develop evidence-based clinical practice guidelines on the treatment of anaphylaxis, with an emphasis on a field-based perspective. The review also included literature regarding the definition, epidemiology, clinical manifestations, and prevention of anaphylaxis. The increasing prevalence of food allergies in the United States raises concern for a corresponding rise in the incidence of anaphylaxis. Intramuscular epinephrine is the primary treatment for anaphylaxis and should be administered before adjunctive treatments such as antihistamines, corticosteroids, and inhaled β agonists. For outdoor schools and organizations, selecting a method to administer epinephrine in the field is based on considerations of cost, safety, and first responder training, as well as federal guidelines and state-specific laws.