100085 - Code Anaphylaxis: enhancing the management of Hymenoptera venom anaphylaxis

Despite the existence of published guidelines and recommendations, the management of anaphylaxis is far from optimal. To determine whether the implementation of a Code Anaphylaxis, designed to improve anaphylaxis management (September 2021) has any impact on the care of patients with anaphylaxis.

A population of 219 adult patients with anaphylaxis due to Vespidae venom (February 2019-November 2023) was analyzed (n=134, pre-Code; and n=85, post-Code). Variables measured before and after the Code were: administration of adrenaline, collection of a sample to measure serum tryptase after the reaction, prescription of an adrenaline autoinjector at discharge, and time elapsed from reaction to attended care in our allergy department.

Although there was no difference in the frequency of adrenaline use between the two periods (47% and 51%), these figures are higher than those previously reported. The Anaphylaxis Code was associated with an increase in post-reaction tryptase determinations (23.1% pre-Code vs. 50.6% post-Code, p<0.001) and a decrease in the time between reaction and visit to a specialized allergy service (median, 20 days [IQR: 7-98] in the pre-Code period vs. median, 11 days [IQR: 7-32] in the post-Code period; p= 0.030).

The implementation of Code Anaphylaxis has led to significant improvements in the management of anaphylaxis after Vespidae stings, particularly in the measurement of serum tryptase and specialist referral. These findings underscore the effectiveness of structured protocols in optimizing emergency anaphylaxis care and underscore the need for ongoing efforts to ensure adherence to treatment guidelines.