Summary of evidence
We found little robust evidence about the most effective strategies to
diagnose, manage or prevent anaphylaxis. There were only three areas
where the certainty of evidence was not ‘very low’. Firstly, newer /
modified models of adrenaline autoinjectors may slightly increase the
proportion of people correctly using the devices and reduce the time
taken to administer adrenaline. Secondly, face-to-face training probably
improves knowledge about anaphylaxis in people at risk of anaphylaxis
and their family and may slightly improve laypeople’s competence in
administering adrenaline autoinjectors. Face-to-face training can be of
varying duration and content, but there is little evidence about the
most effective type of training. Thirdly, adrenaline prophylaxis prior
to snake bite anti-venom may reduce anaphylaxis. However, this evidence
comes largely from Asia and may relate to types of anti-venoms that are
not commonly used in other parts of the world.
For all other diagnostic and management interventions, the evidence was
of too low certainty to draw conclusions. We searched for but found no
eligible studies examining treatments that have been considered as
adjuncts to adrenaline such as fluid replacement, oxygen,
glucocorticosteroids (apart from for antivenom), methylxanthines and
bronchodilators.