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Anaphylaxis: assessment and referral after emergency treatment

  • NICE guideline
  • Reference number: NG258
  • Published:  27 May 2026
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  • Overview
  • Using this guideline
  • Documenting suspected anaphylaxis
  • Timing of blood samples
  • Period of observation
  • Admission to inpatient care
  • Referral to a specialist allergy service
  • Discharge from A&E or inpatient care
  • Terms used in this guideline
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  • Finding more information and committee details
  • Update information

Update information

May 2026: We have produced new recommendations on period of observation and admission to inpatient care based on the Resuscitation Council UK's emergency treatment of anaphylaxis 2021 guideline (section 8.2).

We have amended recommendation 1.1.15 on adrenaline auto-injectors based on:

  • Medicines and Healthcare products Regulatory Agency's (MHRA's) guidance about safe use of adrenaline auto-injectors

  • Resuscitation Council UK's guidance (section 8.6)

  • British Society for Allergy and Clinical Immunology's guidance on prescribing adrenaline auto-injector for patients at risk of anaphylaxis.

The updates followed the May 2026 surveillance review.

August 2020: Advice was added that people should carry their adrenaline injectors with them at all times.

ISBN: 978-1-4731-9529-5


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