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Table 3 Clinical criteria for diagnosing anaphylaxis [13, 14]

From: Anaphylaxis

Anaphylaxis is highly likely when any 1 of the following 3 criteria is fulfilled following exposure to an allergen

1

Acute onset of an illness (minutes to several hours) with involvement of the skin, mucosal tissue, or both (e.g., generalized hives, pruritus or flushing, swollen lips-tongue-uvula) and at least 1 of the following

 a. Respiratory compromise (e.g. dyspnea, wheeze, bronchospasm, stridor, reduced PEF, hypoxemia)

 b. Reduced BP or associated symptoms of end-organ dysfunction (e.g. hypotonia [collapse], syncope, incontinence)

2

Two or more of the following that occur rapidly after exposure to a likely allergen for that patient (minutes to several hours)

 a. Involvement of the skin-mucosal tissue (e.g., generalized hives, itch-flush, swollen lips-tongue-uvula)

 b. Respiratory compromise (e.g., dyspnea, wheeze, bronchospasm, stridor, reduced PEF, hypoxemia)

 c. Reduced BP or associated symptoms (e.g., hypotonia [collapse], syncope, incontinence)

 d. Persistent GI symptoms (e.g., painful abdominal cramps, vomiting)

3

Reduced BP after exposure to a known allergen for that patient (minutes to several hours)

 a. Infants and children: low systolic BP (age specific) or > 30% decrease in systolic BPa

 b. Adults: systolic BP < 90 mmHg or > 30% decrease from that person’s baseline

  1. PEF peak expiratory flow, BP blood pressure, GI gastrointestinal
  2. aLow systolic blood pressure for children is age specific and defined as: < 70 mmHg for age 1 month to 1 year; < 70 mmHg + [2 × age] for age 1–10 years; < 90 mmHg for age 11–17 years