Anaphylaxis is the quintessential medical emergency. While the vast majority of anaphylaxis cases are relatively benign, about 1 percent of these patients die from anaphylactic shock quickly—within about five to 30 minutes of onset. Many of these deaths occur because the anaphylaxis was misdiagnosed and/or the treatment of anaphylaxis and anaphylactic shock was inappropriate.
Anaphylaxis is not simply an acute onset of an itchy rash with hypotension. To the contrary, up to 20 percent of patients do not manifest a rash. Moreover, anaphylaxis can present with isolated hypotension, making the diagnosis even more challenging.
In order for time-sensitive lifesaving treatment to be initiated promptly, it’s imperative that emergency medicine providers understand the diagnostic criteria for anaphylaxis: