Shut up and sit down.

Today I've got with me, Rob Femmwick and I'm a train two, one fire.

Today I've got with me, Rob Venwick, and I'm a trainee ACP at Heart of England NHS Foundation Trust.

What's the topic today, Rob?

So today, Simon, we're going to be talking about anaphylaxis, we're going to be giving

you some pearls and we're going to be picking apart the evidence behind what we do for these

patients.

Great. Okay. Well, one of the most difficult parts of anaphylaxis is actually understanding what it is and I've heard loads of different definitions over the last few years and people will

diagnose it in different ways to other people. So what's a good standard definition we can actually

look at for anaphylaxis?

Well, there's many definitions out there at the moment. You can consider it as an allergic

reaction that affects two systems. So it could affect the skin and the GI. It could affect

respiratory and cardiovascular. That's one way of defining it. Have you heard of any others?

So I was once told by an

immunologist that it's any severe reaction that actually affects anything from behind the teeth. So

the GI tract, cardiovascular and respiratory as you say. But I think when we're all thinking about

what anaphylaxis is in our mind, the picture we've got is of someone who's shut down,

hypotensive, needy adrenaline,

needing fluids and basically needing resuscitation for a life-threatening reaction.

Absolutely. I think a good way of clarifying it and having it clear in your mind is that

it's a severe allergic reaction. And actually the definition, I don't think matters that much to the emergency

clinician who's presented with these patients I think you need to recognize that we've got a patient

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