NAP 6 Perioperative Anaphylaxis Allergy Clinic Perceptions The

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NAP 6: Perioperative Anaphylaxis Allergy Clinic Perceptions: The NAP 6 Baseline survey Prof. William

NAP 6: Perioperative Anaphylaxis Allergy Clinic Perceptions: The NAP 6 Baseline survey Prof. William Egner Consultant Immunologist

NAP 6: Perioperative Anaphylaxis Guidelines used NICE CG 183 • N 1 written information

NAP 6: Perioperative Anaphylaxis Guidelines used NICE CG 183 • N 1 written information • • • N 1. 1 Allergic or non-allergic reaction N 1. 2 Drug name and a description of their reaction N 1. 3 Investigations used N 1. 4 Drugs or drug classes to avoid in future N 1. 5 Safe alternative drugs to use N 2. 1 structured written info. to patient AAGBI • MHRA reporting BSACI • • • • B 1 Drug allergy centre with expertise/high throughput B 2 Able to investigate all potential causes B 3 Dedicated drug allergy clinic B 4. 1 Skin testing B 4. 1 Drug challenge where necessary B 5 Identify the cause and recommend safe future use. B 6 Detailed report to referrer+GP; short report to patient B 7 Anaesthetist— report to MHRA B 8. 1 Identify the cause of the reaction B 8. 2 Identify drugs likely to be safe for future anaesthesia B 8. 3 Written report to referring consultant, GP and surgeon B 8. 4 Provide patient with a brief “to whom it may concern” letter B 8. 5 Provide patient with an “alert” and specific wording B 8. 6 Report to MHRA B 9 Clinic nurse with specialist allergy experience

NAP 6: Perioperative Anaphylaxis Where are the Specialist Po. A clinics?

NAP 6: Perioperative Anaphylaxis Where are the Specialist Po. A clinics?

NAP 6: Perioperative Anaphylaxis Adherence to BSACI Guidance

NAP 6: Perioperative Anaphylaxis Adherence to BSACI Guidance

communication NAP 6: Perioperative Anaphylaxis

communication NAP 6: Perioperative Anaphylaxis

NAP 6: Perioperative Anaphylaxis MHRA Reporting

NAP 6: Perioperative Anaphylaxis MHRA Reporting

NAP 6: Perioperative Anaphylaxis Delay in clinic assessments

NAP 6: Perioperative Anaphylaxis Delay in clinic assessments

NAP 6: Perioperative Anaphylaxis NMBA testing

NAP 6: Perioperative Anaphylaxis NMBA testing

NAP 6: Perioperative Anaphylaxis Tests used

NAP 6: Perioperative Anaphylaxis Tests used

NAP 6: Perioperative Anaphylaxis What did they believe they do well? • • •

NAP 6: Perioperative Anaphylaxis What did they believe they do well? • • • Comprehensive assessments Achieving Diagnosis Communication with health care professionals Avoidance advice Early access for urgent cases

NAP 6: Perioperative Anaphylaxis Where was there room for improvement? • Communication – Reaction

NAP 6: Perioperative Anaphylaxis Where was there room for improvement? • Communication – Reaction and investigation details • Testing – chlorhexidine, NMBA and latex • Waiting times for clinic • MHRA reporting

NAP 6: Perioperative Anaphylaxis Thank you

NAP 6: Perioperative Anaphylaxis Thank you