Shonna’s Summaries: A New Anaphylaxis Definition, Overview, and Tool for Clinicians

by Shonna Snyder

This blog post is part of a regular series of blog posts aimed at summarizing academic journal articles, in order to provide the community with more accessible information, based on recently published scientific research, to share with their care teams.

This week we are exploring the article entitled Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report-a GA2LEN project [1] to learn more about recently updated guidelines for anaphylaxis.

Historically, anaphylaxis has been defined and treated using a multitude of different criteria and physicians mostly relied on patient reported triggers to determine what their next steps would be to treat the patient. Although epinephrine has been considered the first line treatment option, the different criteria for defining and treating anaphylaxis has caused inconsistent and suboptimal patient care over time. 

A brief timeline of anaphylaxis guidelines:

In 2023, the Global Allergy and Asthma Excellence Network (GA2LEN) formed a working group that went through a process of determining a more global criteria for all to use. The group worked to create consensus around three categories of anaphylaxis: definition, overview, and clinical support tool. There were 36 organizations that endorsed the final outputs, which were designed to be recognized across all medical fields.

The anaphylaxis overview (see referenced article) created by the group is meant to educate health care professionals about recognition and management. It provides clear recommendations on patient care when there is sound scientific evidence, and yet, does not provide recommendations when there is no evidence and instead points to the best guidance, reviews, and practice parameters that are available. 

The definition gained consensus from the expert panel, which included patient advocacy organizations, by ensuring that the phrase “may cause death” was included. While it is uncommon for death to occur via anaphylaxis, the patient advocacy organizations felt that the phrase showed the seriousness of anaphylaxis and that it would remind health care providers of the potential to progress to a more serious outcome. There are also easy-to-understand descriptions of all organ systems involved in anaphylaxis to help the layperson’s understanding.

“The clinical support tool is a significant advancement in anaphylaxis care by incorporating key facets of anaphylaxis recognition and management—clinical criteria, epinephrine treatment indications and dosing, and common and serious findings, including in infants and young children—into one easy-to-use document” (pg. 413).

Key points about the support tool:

• Providers who do not see a lot of anaphylaxis patients will have a recognition and management tool to help them.
• It cuts across age span and clinical settings.
• It helps to determine:
  • the “likelihood” that a patient is experiencing anaphylaxis,
  • if epinephrine is needed and how much,
  • that epinephrine can be provided to a patient even if their disease has not met clinical thresholds, and
  • signs and symptoms, including infants, with user-friendly designs (color-coded).

The tool ONLY includes epinephrine as a first-line therapy.  This was intentional.  The authors want all providers to understand that it should ALWAYS be administered first before other therapies. However, it is emphasized that health care providers’ knowledge of medical history and patient presentation of symptoms should play a key role in whether epinephrine is used or not and this should take precedence over the support tool. This is especially true when the allergen is unknown.

Please share the following tool with your health care providers and be an advocate today!

ATMS would like to remind our community that it is recommended that all patients who have been diagnosed with a mast cell disease carry two doses of epinephrine at all times, even if you have never had anaphylaxis. You can visit our webpage for resources here.

References:

1.           Dribin TE, Muraro A, Camargo CA Jr, Turner PJ, Wang J, Roberts G, Anagnostou A, Halken S, Liebermann J, Worm M, Zuberbier T, Sampson HA; GA(2)LEN Anaphylaxis Study Team. Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report-a GA2LEN project. J Allergy Clin Immunol. 2025 Aug;156(2):406-417.e6. doi: 10.1016/j.jaci.2025.01.021. Epub 2025 Jan 27. PMID: 39880313; PMCID: PMC12301991.