The Resus Council released new guidance on the management of anaphylaxis in 2021


To summarise the key points:


Sudden onset and rapid progression of symptoms


Airway and/or Breathing and/or Circulation problems


Skin and/or mucosal changes (flushing, urticaria, angioedema), but these may be absent in up to 20% of cases

The diagnosis is supported if the person has been exposed to an allergen known to affect them

  • Skin and mucosal changes alone do not indicate an anaphylactic reaction – the presence of Airways, Breathing or Circulation problems is required to make the diagnosis.
  • If in doubt (e.g. patient anxious/hyperventilating/dizziness) treat as anaphylaxis.
  • Skin and mucosal changes are absent in 20% of patients with anaphylaxis.

The first step of management is to call 999 – all patients with anaphylaxis need admission to hospital due to the risk of a biphasic reaction.

Position the patient correctly – lie flat with legs elevated or in a sitting position if short of breath.

Adrenaline is the mainstay of treatment and should be given IM as early as possible. Adrenaline should not be given IV in Primary Care settings.



Check airway and give high flow oxygenMonitor pulse, oximetry, BP, ECG if available.

Repeat IM adrenaline after 5 minutes if no response and give IV fluids. Continue to do so until ambulance arrives.

There is no place for steroids in the new guidance.

Antihistamines may be used to reduce urticaria or angioedema, but have no effect on prevention of biphasic reactions.

How does the course work?

This course uses online learning and the virtual learning environment as tools for you to read, watch, study and engage with material relevant to the course.

Each unit has one or two learning outcomes, which indicate the content, depth, and breadth of learning during that unit. You will also have:

In addition to the module’s contents (videos, workbooks and presentations), on the PCSA Platform, you will also have access to various resources (including reports, tools, templates, techniques and further reading) that are underpinning the modules’ content and that will help you play your part in shaping and contributing to successful PCN working.

You will find these uploaded under each module.