Reframing Anaphylaxis; Roadside to Resus

The Resus Room

Simon Laing

Medicine, Science, Health & Fitness

4.9 • 708 Ratings

🗓️ 14 May 2026

⏱️ 45 minutes

🔗️ Recording | iTunes | RSS

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Summary

Anaphylaxis is one of those conditions we think we have got pretty well sorted. Recognise it early, give adrenaline, support the airway and circulation, and crack on. And in fairness, for the vast majority of patients, that approach works really well. But in this Roadside to Resus episode we take a step back and ask a pretty uncomfortable question, have we actually been thinking about anaphylaxis in the wrong way?

Using some fascinating new evidence from the UK National Child Mortality Database, we explore the emerging understanding that fatal food-triggered anaphylaxis may be much more of a respiratory catastrophe than the classic circulatory collapse we often picture in our heads. The findings are genuinely thought provoking. Many of the fatal paediatric cases reviewed showed overwhelming airway and breathing compromise long before cardiovascular collapse occurred, with deterioration happening frighteningly quickly in the prehospital phase.

We work through the current Resuscitation Council UK and NICE guidance, look at where diagnostic confusion still exists, and discuss why early adrenaline absolutely remains the cornerstone of treatment. But we also explore whether our mental model of anaphylaxis needs updating, particularly when it comes to respiratory assessment, escalation and oxygenation strategies.

We're also incredibly grateful to be joined by Ben McKenzie, who shares the devastating personal story behind the development of the AMAX4 approach and the lessons it holds for all of us managing critically unwell patients in the ED and prehospital environment.

This is a really powerful episode about recognition, trajectory and reframing how we think about severe anaphylaxis.

Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon & Rob

Transcript

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0:00.0	Welcome to the recess room podcast.
0:03.5	Five, four, three, two, one, fire.
0:12.6	So hi, and welcome back to the recess room podcast.
0:15.8	I'm Simon Lang.
0:17.3	And I'm Rothenwick.
0:18.6	And we've got no James Yates, but this is our new episode of
0:21.8	Roadside to Reesisus, I know, I know, dry your eyes, mate. It's our new episode of Roadside
0:28.6	to Reesisus, and this time it's on reframing anaphylaxis. I know, I'm so sad. James
0:34.7	Yates was desperate to come on this episode, but he's off doing obviously very, very important work in whatever he's doing. And we will be back next month, I believe. It's been so long since we were all together. But anyway, I'm sad that he can't be here. I'm very glad that you're joining us. And yeah, we've got a great episode planned in terms of reframing anaphylaxis. And, you know, I think that
0:55.9	the important thing to say here is there is some new concepts coming out of the evidence,
1:00.3	and I am super pleased to be bringing it. And not only us, we have got a third member of the
1:04.5	team this month. We've got an interview with a subject matter expert, haven't we?
1:08.8	We have. We absolutely have. And you're right, James is off doing stuff for a good cause, but I'm not sure that being
1:14.7	sat on your bike is, you know, really a valid excuse to be off not recording on the podcast.
1:19.8	But there we go.
1:20.5	Someone's got to hold the fort, haven't they?
1:23.2	Before we get into it, though, a huge thanks once again to Zol Medical Corporation for collaborating with us on the podcast and making this all free, open access and available to you in their pursuit of excellent patient care.
1:37.8	And when you've listened to this, as we always say, pop over to the website and get your free CPD certificate for listening to it.
1:45.2	So, got some great content in here, so let's crack in to the episode. Okay then, well, anaphylaxis,
1:53.9	something which I think, if I know our listener as well, Simon, most of them will understand
1:59.2	really well. They have seen this out there in
2:01.5	practice. They've got it drilled in. We've done an episode on this before. It's simple.
	...

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