Critical Care Services STH

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Anaesthetic Anaphylaxis Referral Checklist

The following steps need to be completed when an anaesthetic allergy is suspected in order to ensure appropriate follow-up of the patient occurs. Once completed, the anaesthetic allergy clinic will be responsible for investigation of the patient and will contact you and the surgeon with the results.

STEPS to be completed:

Blood sample for mast cell tryptase levels (use a Yellow top bottle):

1st sample taken as soon as possible and marked as “immediate level”
2nd sample taken between one and two hours after the onset of the event and marked as “peak level”
3rd sample taken any time more than 24 hours after the onset of the event and marked as “baseline level”

The exact time of each sample needs to be documented clearly on the blood bottle and form

Complete the referral form (Form A) and send this, along with a photocopy of the anaesthetic chart and a covering letter, to the anaesthetic allergy clinic at the RVI
Complete the letter to patients GP (Form B) detailing the possible causative agent and giving a brief description of the event and its severity
Complete the letter for the patient (Form C) detailing the possible causative agent but where possible this letter should accompany a discussion with the patient about the event
Documentation of the reaction in the hospital case notes including a copy of the referral form

Regarding those patients requiring sedation post-anaphylaxis; the rate of anaphylaxis to propofol is extremely low but consideration should be given to using an alternative such as midazolam.