Imperial College London
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Dr Harriet Kemp

Faculty of Medicine, Department of Surgery & Cancer

Clinical Lecturer
 
 
 
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Contact

 

h.kemp

 
 
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Location

 

Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Egner:2018:10.1111/cea.13180,
author = {Egner, W and Cook, TM and Garcez, T and Marinho, S and Kemp, H and Lucas, DN and Floss, K and Farooque, S and Torevell, H and Thomas, M and Ferguson, K and Nasser, S and Karanam, S and Kong, K-L and McGuire, N and Bellamy, M and Warner, A and Hitchman, J and Farmer, L and Harper, NJN},
doi = {10.1111/cea.13180},
journal = {Clinical and Experimental Allergy},
pages = {846--861},
title = {Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis},
url = {http://dx.doi.org/10.1111/cea.13180},
volume = {48},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe Royal College of Anaesthetists 6th National Audit Project examined Grade 35 perioperative anaphylaxis for 1 year in the UK.ObjectiveTo describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results.MethodsWe used a secure registry to gather details of Grade 35 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail. Panel consensus diagnosis, reaction grade, review of investigations and clinic assessment are reported and compared to the prior NAP6 baseline clinic survey.ResultsA total of 266 cases met inclusion criteria between November 2015 and 2016, detailing reactions and investigations. One hundred and ninetytwo of 266 (72%) had anaphylaxis with a trigger identified, of which 140/192 (75%) met NAP6 criteria for IgEmediated allergic anaphylaxis, 13% lacking evidence of positive IgE tests were labelled “nonallergic anaphylaxis”. 3% were nonIgEmediated anaphylaxis. Adherence to guidance was similar to the baseline survey for waiting time for clinic assessment. However, lack of testing for chlorhexidine and latex, nonharmonized testing practices and poor coverage of all possible culprits was confirmed. Challenge testing may be underused and many have unacceptably delayed assessments, even in urgent cases. Communication or information provision for patients was insufficient, especially for avoidance advice and communication of test results. Insufficient detail regarding skin test methods was available to draw conclusions regarding techniques.Conclusion and Clinical RelevanceCurrent clinical assessment in the UK is effective but harmonization of approach to testing, access to services and MHRA reporting is needed. Expert anaesthetist involvement should increase to optimize diagnostic yield and advice for future anaesthesia. Dynamic tryptase evaluation improves detection of tryptase release where peak tryptase is &l
AU  - Egner,W
AU  - Cook,TM
AU  - Garcez,T
AU  - Marinho,S
AU  - Kemp,H
AU  - Lucas,DN
AU  - Floss,K
AU  - Farooque,S
AU  - Torevell,H
AU  - Thomas,M
AU  - Ferguson,K
AU  - Nasser,S
AU  - Karanam,S
AU  - Kong,K-L
AU  - McGuire,N
AU  - Bellamy,M
AU  - Warner,A
AU  - Hitchman,J
AU  - Farmer,L
AU  - Harper,NJN
DO  - 10.1111/cea.13180
EP  - 861
PY  - 2018///
SN  - 0954-7894
SP  - 846
TI  - Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis
T2  - Clinical and Experimental Allergy
UR  - http://dx.doi.org/10.1111/cea.13180
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000436404000011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/61380
VL  - 48
ER  -
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