Anaphylaxis - 2025
The algorithm Anaphylaxis—2025 focuses on the diagnosis, initial treatment, and prompt management of this life-threatening condition. The teaching material respects the latest therapeutic procedures and takes into account, to an appropriate extent, the subtle changes presented in the latest ERC Guidelines, which were published in October 2025. It offers learners a comprehensive narrative that guides them from pre-hospital care to hospital management.
Review
Anaphylaxis is a life-threatening condition in which early recognition and treatment are of paramount importance. The proposed algorithm provides an interactive and easy-to-follow pathway to correct diagnosis and management, reflecting the current ERC 2025 Guidelines. It emphasizes the key role of immediate adrenaline (epinephrine) administration and, in this particular case, the escalation of treatment with support of failing vital functions. Conversely, it appropriately highlights the traditionally overused corticosteroids and antihistamines, for which convincing evidence of clinical benefit is lacking. The algorithm is very well designed, clear, and highly educational.
Sources
LOTT, Carsten, Vlasios KARAGEORGOS, Cristian ABELAIRAS-GOMEZ, Annette ALFONZO, Joost BIERENS, Steve CANTELLOW, et al. Management and prevention of cardiac arrest due to anaphylaxis. In: European Resuscitation Council Guidelines 2025: Special Circumstances in Resuscitation. Resuscitation. 2025, roč. 215, suppl. 1, article 110753. DOI: 10.1016/j.resuscitation.2025.110753. Online. Available from: https://www.erc.edu/science-research/guidelines/guidelines-2025/guidelines-2025-english/. [quoted 2026-01-13].
Cosme Ferreira S, Fernandes M, Câmara R. Anaphylaxis fast-track system: a pilot project to enhance and standardize anaphylaxis patient care. Eur Ann Allergy Clin Immunol. 2026 Mar 12. doi: 10.23822/EurAnnACI.1764-1489.428. Epub ahead of print. PMID: 41817013. Online. Available from: https://pubmed.ncbi.nlm.nih.gov/41817013/. [quoted 2026-03-20].
Wu, R., Lyons, J.J. Hereditary Alpha-Tryptasemia: a Commonly Inherited Modifier of Anaphylaxis. Curr Allergy Asthma Rep 21, 33 (2021). Online. Available from: https://link.springer.com/article/10.1007/s11882-021-01010-1. [quoted 2026-03-20]
Abouelmagd K, Alhaddad J, Oyedele TJ, Ali RR, Nahla UA, Carr LA, Alsabri M. Post-anaphylaxis observation in the ED: a decade of data challenging the traditional 24-hour rule. Int J Emerg Med. 2026 Mar 14;19(1):63. doi: 10.1186/s12245-026-01175-4. PMID: 41832433; PMCID: PMC12990544. Online. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12990544/. [quoted 2026-03-20].
Walters B, Short HB, Ravida N, Fabe M, Boehmer S, Reyes L. Evaluating Practice Patterns of Observation Periods Status Post Epinephrine Administration for Anaphylaxis. J Emerg Med. 2025 Oct;77:69-76. doi: 10.1016/j.jemermed.2025.07.001. Epub 2025 Jul 11. PMID: 40857992. Online. Available from: https://pubmed.ncbi.nlm.nih.gov/40857992/. [quoted 2026-04-01].
Learning targets
2. The student knows the treatment of anaphylaxis according to the latest ERC guidelines 2025.
3. The student can manage a patient in critical condition
according to the ABCDE approach.
Key points
2. The current role of corticosteroids and antihistamines in treatment.
3. Tryptase and its levels play a role in the post-anaphylactic state when an immunopathological reaction is aimed to be confirmed.
