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Anaphylaxis occurs more frequently than previously believed. Therefore, proper knowledge regarding the epidemiology, mechanisms, symptoms, diagnosis, and treatment of anaphylaxis is essential. In particular, the initial treatment strategy, followed by correct diagnosis, in the emergency room is critical for preventing fatal anaphylaxis, although making a diagnosis is not easy because of the broad and often atypical presentation of anaphylaxis. To this end, the clinical criteria proposed by the National Institute of Allergy and Infectious Diseases and the Food Allergy and Anaphylaxis Network are useful, which, together with a differential diagnosis, could enable a more accurate diagnosis. Additional <jats:italic>in vitro<\/jats:italic> tests, such as plasma histamine and tryptase measurements, are also helpful. It should be emphasized that adrenaline is the only drug recommended as first\u2010line therapy in all published national anaphylaxis guidelines. Most international anaphylaxis guidelines recommend injecting adrenaline by the intramuscular route in the mid\u2010anterolateral thigh, whereas i.v. adrenaline is an option for patients with severe hypotension or cardiac arrest unresponsive to intramuscular adrenaline and fluid resuscitation. In addition to the route of administration, choosing the appropriate dose of adrenaline is essential, because serious adverse effects can potentially occur after an overdose of adrenaline. Furthermore, to avoid future recurrence of anaphylaxis, providing adrenaline auto\u2010injectors and making an etiological diagnosis, including confirmation of the offending trigger, are recommended for patients at risk of anaphylaxis before their discharge from the emergency room.<\/jats:p>","DOI":"10.1002\/ams2.282","type":"journal-article","created":{"date-parts":[[2017,5,15]],"date-time":"2017-05-15T11:08:43Z","timestamp":1494846523000},"page":"235-245","source":"Crossref","is-referenced-by-count":12,"title":["Drug\u2010induced anaphylaxis in the emergency room"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0119-3532","authenticated-orcid":false,"given":"Tomonori","family":"Takazawa","sequence":"first","affiliation":[{"name":"Intensive Care Unit Gunma University Hospital Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohiro","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Gunma University Graduate School of Medicine Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.12.1303"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(95)70329-2"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.09.030"},{"key":"e_1_2_12_5_1","first-page":"288","article-title":"Anaphylaxis in adolescent\/adult patients treated in the emergency department: differences between initial impressions and the definitive diagnosis","volume":"25","author":"Alvarez\u2010Perea A","year":"2015","journal-title":"J. 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