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  • Question on Document

    Proposed new recommendations 1.3.1 to 1.3.4 post-anaphylaxis observation periods for children and adults. Do you agree with the proposal to update CG134 recommendations about post-anaphylaxis observation periods with the Resuscitation Council UK’s recommendations? Yes/no. Please provide a rationale for your decision

  • Question on Document

    Proposed new recommendation 1.4.1 admission of children who cannot be safely discharged. This recommendation has been added to make it clear how children who do not meet criteria in proposed recommendations 1.3.1 to 1.3.4 should be cared for. Do you agree with the proposal to recommend that children younger than 16 years who cannot be discharged using the discharge criteria recommended by new proposed recommendations 1.3.1 to 1.3.4 should be admitted under the care of a paediatric medical team? Yes/no. Please provide a rationale for your decision

  • Question on Document

    Proposed new recommendation 1.4.3 offer of adrenaline auto-injectors following emergency treatment for suspected anaphylaxis and when they should be offered. This recommendation has been updated to reflect advice from the MHRA on adrenaline autoinjectors and to align with British Society for Allergy and Clinical Immunology and Resuscitation Council UK guidance about when they should be offered. Do you agree that people should be offered 2 adrenaline auto-injectors as an interim measure before they attend for a specialist allergy appointment, unless the suspected anaphylaxis was due to a drug allergy that can be easily avoided. Yes/no. Please provide a rationale for your decision

  • Question on Document

    Amended recommendation 1.5.1 discharge practice. This recommendation has been amended for consistency with proposed recommendations 1.3.1 to 1.3.4, including the addition of a new bullet which clarifies discharge recommendations for people who have experienced suspected anaphylaxis due to a drug allergy where the drug is subsequently easily avoided. Do you agree with the amended bulleted recommendation? Yes/No. Please provide a rationale for your decision.

  • Question on Document

    Are there any health inequalities issues related to the draft recommendations that you think need to be considered?

Anaphylaxis: assessment and referral after emergency treatment: Draft for consultation

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We have updated this service so that members of the same organisation can now collaborate on a joint online response.

Read our blog to learn more.

Overview

This guideline covers assessment and referral for anaphylaxis. It aims to improve the quality of care for people with suspected anaphylaxis by detailing the assessments that are needed and recommending referral to specialist allergy services.

NICE has also produced a guideline on drug allergy.

This guideline will update NICE guideline CG134 (published 2011, amended 2020).

Who is it for?

  • Healthcare professionals

  • Commissioners and providers

  • People with suspected anaphylaxis and their families and carers

What does it include?

  • the recommendations

  • the guideline context.

New and updated recommendations

We have updated the recommendations on period of observation following treatment for suspected anaphylaxis to bring them in line with guidance from the Resuscitation Council UK.

We have also updated 2 recommendations on admission and referral for consistency with the new recommendations on observation following treatment and to incorporate advice from the MHRA and the British Society for Allergy and Clinical Immunology (BSACI), on the provision of autoinjectors. You are invited to comment on the new and updated recommendations by answering the questions on the consultation page. New recommendations are marked as [2026].

We have also made some minor changes to the structure of the guideline, including introducing sub-headings to improve navigation.

See update information for a full explanation of what is being updated.