{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T08:41:45Z","timestamp":1761986505076,"version":"3.37.3"},"reference-count":9,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,9,7]],"date-time":"2017-09-07T00:00:00Z","timestamp":1504742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6<jats:sup>th<\/jats:sup> National Audit Project.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We compare self\u2010declared <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> practice in specialist perioperative allergy services with national recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A SurveyMonkey\u2122 questionnaire was distributed to providers of allergy services in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (<jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content>) Guidance on Drug Allergy\u2014<jats:styled-content style=\"fixed-case\">CG<\/jats:styled-content>183.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait &gt;13 weeks) in contrast to adult centres (most wait &lt;12 weeks). Service leads are allergists\/immunologists (91%) or anaesthetists (7%).<\/jats:p><jats:p>Potentially important differences were seen in: <jats:italic>testing repertoire<\/jats:italic> [10\/44 (23%) lacked BSACI compliant neuromuscular blocking agent (NMBA) panels and 17\/44 (39%) lacked a <jats:styled-content style=\"fixed-case\">NAP<\/jats:styled-content>6\u2010defined extended panel; many failed to screen all cases for chlorhexidine 19\/44 (43%) or latex 21\/44 (48%)], <jats:italic>staffing<\/jats:italic> [only 26\/44 (59%) had specialist nurses and 18\/44 (41%) an anaesthetist] and <jats:italic>provision of information<\/jats:italic> [18\/44 (41%) gave immediate information in clinic and 5\/44 (11%) sign\u2010posted support groups].<\/jats:p><jats:p>Most centres were able to provide <jats:italic>diagnostic challenges<\/jats:italic> to antibiotics [40\/44 (91%]) and local anaesthetics [41\/44 (93%)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Clinical Relevance<\/jats:title><jats:p>Diagnostic testing is not harmonized, with marked variability in the <jats:styled-content style=\"fixed-case\">NMBA<\/jats:styled-content> panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres.<\/jats:p><jats:p>Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum <jats:styled-content style=\"fixed-case\">NMBA<\/jats:styled-content> panel for identification of safe alternatives.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.12993","type":"journal-article","created":{"date-parts":[[2017,8,8]],"date-time":"2017-08-08T23:44:02Z","timestamp":1502235842000},"page":"1318-1330","source":"Crossref","is-referenced-by-count":14,"title":["Specialist perioperative allergy clinic services in the <scp>UK<\/scp> 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2654-9881","authenticated-orcid":false,"given":"W.","family":"Egner","sequence":"first","affiliation":[{"name":"Clinical Immunology and Allergy Unit Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Cook","sequence":"additional","affiliation":[{"name":"Anaesthesia and Intensive Care Medicine Royal United Hospital Bath NHS Trust Bath UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Harper","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Central Manchester University Hospitals NHS Foundation Trust Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Garcez","sequence":"additional","affiliation":[{"name":"Immunology and Allergy Central Manchester University Hospitals NHS Foundation Trust Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Marinho","sequence":"additional","affiliation":[{"name":"Manchester Academic Health Science Centre NIHR Translational Research Facility in Respiratory Medicine The University of Manchester University Hospital of South Manchester NHS Foundation Trust Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. L.","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Sandwell and West Birmingham Hospitals NHS Trust City Hospital Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Nasser","sequence":"additional","affiliation":[{"name":"Department of Allergy &amp; Clinical Immunology Addenbrooke's NHS Trust Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Aneasthetics Great Ormond Street Hospital For Children NHS Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Warner","sequence":"additional","affiliation":[{"name":"Clinical Services Allergy UK Sidcup UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Hitchman","sequence":"additional","affiliation":[{"name":"The Royal College of Anaesthetists Lay Committee Royal College of Anaesthetists London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Floss","sequence":"additional","affiliation":[{"name":"Pharmacy Department Oxford University Hospitals NHS Foundation Trust Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Sixth national audit project (NAP6) steering & Case Review panel, RCoA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2009.03404.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2008.05733.x"},{"volume-title":"Drug Allergy: Diagnosis and Management of Drug Allergy in Adults, Children and Young People [internet]","year":"2014","author":"CG183 N","key":"e_1_2_8_4_1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.2010.100253"},{"key":"e_1_2_8_6_1","unstructured":"Specialised allergy services (all ages) B09\/S\/b [internet].NHS England Specialist Services;2016.https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2013\/06\/b09-spec-allergy.pdf. Accessed February 08 2017."},{"key":"e_1_2_8_7_1","unstructured":"Paediatric Medicine: Specialised Allergy services E03\/S\/j [internet].NHS England Specialist Services;2016.https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2013\/06\/e03-paedi-medi-allergy.pdf. 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