Wangberg Hannah, White Andrew A
Division of Allergy, Asthma, and Immunology, Scripps Clinic, 3811 Valley Centre Dr. S99, San Diego, CA, 92130, USA.
Curr Allergy Asthma Rep. 2025 Jul 8;25(1):29. doi: 10.1007/s11882-025-01210-z.
In this review we explore expanding options for monitoring following anaphylaxis in the home or community setting. We review recent literature to help identify who might benefit from watchful waiting at home versus immediate emergency medical service (EMS) activation following anaphylaxis.
Recent studies confirm that most patients respond promptly, completely, with a durable response to a single dose of epinephrine for anaphylaxis. In monophasic anaphylaxis, reflexive emergency monitoring has been found to have minimal benefit. In recent years, studies show increasing emergency department utilization for anaphylaxis, though the risk of fatal anaphylaxis remains exceedingly low. Identifying patients at risk for severe anaphylaxis is imprecise, though several risk factors have been associated with higher chances of severe reactions. Reflexive emergency monitoring following anaphylaxis is not necessary in all cases of anaphylaxis. Carefully selected patients may benefit from watchful waiting at home. Engaging in shared decision making is critical in this new era of personalized allergy action plans. Future studies are necessary to refine our understanding of the full risks and benefits of home monitoring following anaphylaxis.
在本综述中，我们探讨了在家庭或社区环境中监测过敏反应的更多选择。我们回顾近期文献，以帮助确定在过敏反应后哪些人可能从在家观察等待中受益，而哪些人需要立即呼叫紧急医疗服务（EMS）。
近期研究证实，大多数患者对单剂量肾上腺素治疗过敏反应反应迅速、完全且持久。在单相过敏反应中，常规的紧急监测益处不大。近年来，研究表明因过敏反应而前往急诊科就诊的人数有所增加，尽管致命性过敏反应的风险仍然极低。虽然有几个风险因素与严重反应的较高几率相关，但识别严重过敏反应风险患者并不准确。并非所有过敏反应病例都需要在过敏反应后进行常规紧急监测。经过精心挑选的患者可能在家观察等待中受益。在这个个性化过敏行动计划的新时代，参与共同决策至关重要。未来有必要开展研究，以完善我们对过敏反应后家庭监测的全部风险和益处的理解。
