{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:40:35Z","timestamp":1747183235974,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anaphylaxis is a severe, potentially life\u2010threatening generalized or systemic hypersensitivity reaction. Sequential reports have cited anaphylaxis as the most common cause of anaesthesia\u2010related deaths. We undertook an audit at a quaternary centre, examining the management of perioperative anaphylaxis and quality of referrals made to our anaesthesia allergy testing service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data of 41 patients consulted at St Vincent's Hospital Melbourne for perioperative anaphylaxis between 17th of January 2020 and 20th of January 2022 were analysed. Intervention outcomes included total intravenous fluid administered, adrenaline administration, instigation of CPR and the collection and the timing of serum tryptase samples. We also assessed referral quality, provision of institutional allergy alert and time elapsed from the anaphylaxis event to allergy testing. Contemporaneous Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) guidelines were used as the reference standard for most outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our data reveals compliance of &lt;80% with respect to intravenous fluid administration, referral quality and tryptase sampling, particularly at the 4\u2010h timepoint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgical leadership and patient advocacy in the post\u2010acute phase would likely facilitate requisite testing and improve the quality of counselling. We recommend institutions adopt a case\u2010by\u2010case review of management compliance with recommendations. Additionally, we advocate for the inclusion of a prompt to the ANZAAG referral form, that encourages the operator to update their patient's institutional allergy alert while awaiting allergy testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18499","type":"journal-article","created":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T05:22:48Z","timestamp":1683177768000},"page":"2621-2625","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative anaphylaxis management and testing: a quaternary centre audit"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-1209","authenticated-orcid":false,"given":"Adam","family":"Lipszyc","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Acute Pain Medicine St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Acute Pain Medicine St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Acute Pain Medicine St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.05.001"},{"key":"e_1_2_8_3_1","unstructured":"Mortality Sub\u2010Committee of the Australian and New Zealand College of Anaesthetists.Safety of anaesthesia: a review of anaesthesia\u2010related mortality reporting in Australia and New Zealand 2012\u20132014 [Internet]. 28 p.2015. [Cited 1 Apr 2022.] Available from URL:https:\/\/www.anzca.edu.au\/getattachment\/759c7693-8062-4fcc-95dc-663156736f0e\/Safety-of-Anaesthesia-report-(2012-2014)"},{"key":"e_1_2_8_4_1","unstructured":"Mortality Sub\u2010Committee of Australian and New Zealand College of Anaesthetists.Safety of anaesthesia: a review of anaesthesia\u2010related mortality reporting in Australia and New Zealand [Internet].2018. [Cited 1 Apr 2022.] Available from URL:https:\/\/www.anzca.edu.au\/resources\/incident-reporting-docs\/safety-of-anaesthesia-(mortality)-reports\/safety-of-anaesthesia-report-2015-2017.pdf"},{"key":"e_1_2_8_5_1","unstructured":"ANZAAG.ANZAAG\/ANZCA anaphylaxis management guidelines [Internet].2016. [Cited 1 Apr 2022.] Available from URL:https:\/\/anzaag.com\/anaphylaxis-management\/management-resources\/"},{"key":"e_1_2_8_6_1","unstructured":"ANZCA & FPM.Continuing professional development program handbook [Internet].2023. [Cited 1 Apr 2022.] Available from URL:https:\/\/www.anzca.edu.au\/getattachment\/a2eb3ff8-d9fc-4bfb-94a7-8d6ee4980a00\/2023-ANZCA-and-FPM-CPD-Program-Handbook"},{"key":"e_1_2_8_7_1","unstructured":"ScolaroRJ CrillyHM MaycockEJ et al.ANZAAG Perioperative Anaphylaxis Investigation Guidelines Australian and New Zealand Anaesthetic Allergy Group Perioperative Anaphylaxis Investigation Guidelines [Internet]. Vol. 45 Anaesth Intensive Care.2017. [Cited 1 Apr 2022.] Available from URL:http:\/\/www.anzaag.com\/anaphylaxis-management\/testing-guidelines.pdf."},{"volume-title":"NAP6: Anaesthesia, Surgery and Life\u2010Threatening Allergic Reactions [Internet]","year":"2018","author":"Cook T","key":"e_1_2_8_8_1"},{"key":"e_1_2_8_9_1","unstructured":"ANZAAG.Referral form [Internet].2021. [Cited 1 Apr 2022.] Available from URL:https:\/\/media.anzaag.com\/2022\/09\/26105357\/ANZAAG-Referral-Form-V6.pdf"},{"key":"e_1_2_8_10_1","unstructured":"Australian Government Department of Health and Aged Care.Rural remote and metropolitan area [Internet].2021. [Cited 1 Apr 2022.] Available from URL:https:\/\/www.health.gov.au\/topics\/rural-health-workforce\/classifications\/rrma"},{"key":"e_1_2_8_11_1","unstructured":"PedersenK RoesslerP TranR.Perioperative anaphylaxis management guideline background paper [Internet]. Melbourne.2020. [Cited 12 Sept 2022.] Available from URL:https:\/\/media.anzaag.com\/2022\/11\/22130754\/Anaphylaxis-Mx-Guideline-BP-Nov2022.pdf"},{"key":"e_1_2_8_12_1","unstructured":"ASCIA.Acute management of anaphylaxis [Internet].2023. [Cited 10 Feb 2023.] Available from URL:https:\/\/www.allergy.org.au\/images\/ASCIA_HP_Guidelines_Acute_Management_Anaphylaxis_2023.pdf"},{"key":"e_1_2_8_13_1","unstructured":"AAGBI.Quick Reference Handbook\u2014Guidelines for crises in anaesthesia [Internet].2022. [Cited 10 Feb 2023.] Available from URL:https:\/\/anaesthetists.org\/Home\/Resources-publications\/Safety-alerts\/Anaesthesia-emergencies\/Quick-Reference-Handbook-QRH\/Word-version"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.01.031"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2022.12.014"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1804600605"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0803600210"},{"key":"e_1_2_8_18_1","unstructured":"RingJ MessmerK.Incidence and severity of anaphylactoid reactions to colloid volume substitutes [Internet]. Vol. 9 J. H. Reorganised Health Service. Oxford Regional Hospital Board.1977. [Cited 1 Apr 2022.] Available from URL:https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0140673677919535"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.18499","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T10:56:23Z","timestamp":1709204183000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.18499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,3]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/ans.18499"],"URL":"https:\/\/doi.org\/10.1111\/ans.18499","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"type":"print","value":"1445-1433"},{"type":"electronic","value":"1445-2197"}],"subject":[],"published":{"date-parts":[[2023,5,3]]},"assertion":[{"value":"2023-04-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}