PT  - JOURNAL ARTICLE
AU  - Andrew Clark
AU  - Kate Lloyd
AU  - Aziz Sheikh
AU  - Mazin Alfaham
AU  - Mandy East
AU  - Pamela Ewan
AU  - Fiona Jewkes
AU  - Rosie King
AU  - Susan Leech
AU  - Ian Maconochie
AU  - Louise Sinnott
AU  - Dalbir Sohi
AU  - Stephen Tomlin
AU  - John Warner
TI  - The RCPCH care pathway for children at risk of anaphylaxis: an evidence and consensus based national approach to caring for children with life-threatening allergies
AID  - 10.1136/adc.2011.212662
DP  - 2011 Nov 01
TA  - Archives of Disease in Childhood
PG  - i6--i9
VI  - 96
IP  - Suppl 2
4099  - http://adc.bmj.com/content/96/Suppl_2/i6.short
4100  - http://adc.bmj.com/content/96/Suppl_2/i6.full
SO  - Arch Dis Child2011 Nov 01; 96
AB  - Aims Numerous studies have identified shortcomings in the management of children at risk of severe acute allergic reactions (anaphylaxis). The Science and Research Department at the Royal College of Paediatrics and Child Health (RCPCH) was commissioned by the Department of Health to develop competence based national care pathways for children with allergies. Anaphylaxis is the first completed pathway. Methods The anaphylaxis pathway was developed by a multidisciplinary working group, reviewed by a broad group of stakeholders and approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee. Results Pathway development is described under five headings: evidence review, mapping, external review, core knowledge documents and key recommendations. The full pathway can be downloaded from www.rcpch.ac.uk/allergy/anaphylaxis. This document describes the entry points and the ideal pathway of care from self-care through to follow-up. The five key recommendations focus on: (1) prompt administration of adrenaline by intramuscular injection; (2) referral to specialists with competence in paediatric allergies; (3) risk analysis; (4) provision of a self-management plan; and (5) suggested creation of a national anaphylaxis death register. Conclusions We present the first national care pathway for anaphylaxis, which is based on a critique of published evidence, expert consensus and multi-stakeholder input including patient representation via the Anaphylaxis Campaign. The Project Board urges health professionals to work together across networks to improve care for children at risk of anaphylaxis, in particular during the period after an acute reaction. Additionally, the Project Board strongly recommends the funding of a national anaphylaxis register.