anaphylaxis
Enable an agent to recognise a suspected anaphylaxis episode, track its clinical trajectory and support timely escalation, evidence capture and recurrence prevention.
Research draft, second pass
A second pass drafted this model: the structure a model of this thing needs, and what is known about it in the world. The line under this one says how the second half was obtained - researched against sources, or recalled without web access, in which case nothing here was read anywhere and every claim is a lead to verify. Unreviewed either way.
recalled by Codex without web access - no source was read
Researched by: Codex
Purpose and description
Enable an agent to recognise a suspected anaphylaxis episode, track its clinical trajectory and support timely escalation, evidence capture and recurrence prevention.
Anaphylaxis is a serious systemic hypersensitivity reaction, usually rapid in onset, that may cause death through life-threatening airway, breathing or circulatory compromise and can occur without skin findings or shock.
It can be Compare observed manifestations with a named anaphylaxis recognition framework and expose missing observations.; Flag suspected anaphylaxis for immediate emergency escalation under the applicable clinical protocol.; Construct a timeline connecting exposures, manifestations, interventions and subsequent changes.; Track unresolved airway, breathing or circulation problems and route them to qualified responders.; Prepare an episode handover that separates observations, reported history and causal hypotheses.; Identify incomplete specialist referral, trigger investigation and personalised emergency-plan tasks..
Distinguishing features
Evaluate an acute clinical pattern against a named criteria set; an allergy label or exposure alone does not establish anaphylaxis.
Skin findings are not mandatory: qualifying acute airway, respiratory or circulatory manifestations after a known or highly probable allergen can meet WAO criteria. [WAO guidance](https://pmc.ncbi.nlm.nih.gov/articles/7607509/)
Isolated hives do not by themselves satisfy WAO anaphylaxis criteria; record associated organ involvement and exposure context. [WAO guidance](https://pmc.ncbi.nlm.nih.gov/articles/7607509/)
Anaphylactic shock denotes circulatory failure associated with anaphylaxis; anaphylaxis does not require shock. [WAO guidance](https://pmc.ncbi.nlm.nih.gov/articles/7607509/)
Separate the acute episode from continuing susceptibility: an individual may remain at risk after the episode resolves.
Scope
+ Episode recognition using explicitly identified clinical criteria and diagnostic uncertainty
+ Exposure chronology, suspected triggers and contributing cofactors
+ Organ involvement, physiological deterioration and response to intervention
+ Resolution, persistent symptoms and recurrence within the episode
+ Episode-linked investigation, specialist assessment and prevention planning
- Allergic sensitisation and chronic allergy management beyond their relationship to an episode
- Isolated urticaria or local allergic reactions without anaphylaxis
- Independent models of asthma, vasovagal syncope and other diagnostic alternatives
- Drug formulation, prescribing rules and autoinjector engineering
- General shock, cardiac arrest and intensive-care management
- Underlying mast-cell disorders as independently managed conditions
Characteristics
- Diagnostic assessment
- suspected | criteria-supported | uncertain | alternative diagnosis favoured; criteria authority, version and assessor Preserves the distinction between urgent working recognition and subsequent diagnostic review.
- Exposure-to-onset interval
- minutes or hours, with timestamp uncertainty and candidate exposure Supports causal assessment without assuming that the nearest exposure caused the episode.
- Organ involvement
- skin/mucosa | upper airway | lower respiratory | cardiovascular | gastrointestinal; present, absent or unassessed for each Makes the observed syndrome assessable against recognition criteria.
- Physiological trajectory
- blood pressure in mmHg, heart rate in beats/min, respiratory rate in breaths/min and oxygen saturation in %, each timestamped Supports assessment of deterioration and recovery with age, baseline and treatment context.
- Trigger attribution
- episode linked to candidate food, medicine, venom, latex or other exposure; suspected, supported, excluded or unresolved Prevents a provisional trigger from becoming an unquestioned permanent allergy label.
- Clinical course
- evolving | improving | apparently resolved | persistent | recurrent; definitions and observation interval recorded Separates momentary improvement from the assessed course of the episode.
- Intervention-response relationship
- intervention, administration time, dose and route where applicable, followed by timestamped observations Makes treatment history and apparent response reviewable without treating response as diagnostic proof.
- Acute and baseline tryptase
- ng/mL, sampling times relative to onset, assay reference information and paired baseline when available Supports investigation while preserving the limitation that normal tryptase does not exclude anaphylaxis. [WAO guidance](https://pmc.ncbi.nlm.nih.gov/articles/7607509/)
Also called
Where this came from
wikidata · CC0 1.0
Drafted structure
Bundle to layer to finding to question, as the second pass will find it: 6 bundles · 11 layers · 18 findings · 28 questions.
Syndrome recognition Determine whether the observed episode supports anaphylaxis and make the basis of that judgement explicit.
Recognition depends on a clinical pattern, exposure context and the criteria used, rather than a single defining measurement.
Clinical criteria
Represent the applicable definition and its mapping to observed manifestations.
Criteria-to-observation match
Record the criteria authority and version, each supporting observation and unresolved requirements; distinguish missing observations from negative findings.
- Which definition and diagnostic criteria are being applied, and for which clinical setting? definition
- Which timestamped manifestations support each criterion, including presentations without skin findings? measurement
Diagnostic boundaries
Keep anaphylaxis distinct from adjacent syndromes and narrower complications.
Alternatives and shock status
Capture evidence for competing explanations and assess circulatory failure separately from the overall anaphylaxis judgement.
- What observations distinguish this episode from isolated urticaria, acute asthma, vasovagal syncope or a nonallergic cause of airway swelling? boundary
- Is circulatory failure present, absent or unassessed, and what evidence supports that assessment? measurement
Exposure and causation Connect the episode to possible elicitors without overstating causal certainty.
Emergency recognition and later trigger attribution are different judgements with different evidence requirements.
Exposure chronology
Reconstruct relevant exposures and their timing relative to symptom onset.
Candidate trigger history
Maintain competing exposure hypotheses, including route, amount when known, repeated administration and the reliability of reported times.
- Which foods, medicines, stings, materials or other exposures preceded onset, by what routes and at what times? provenance
- Which timing details were directly recorded, recalled by the patient or inferred after the event? provenance
Cofactors and attribution
Separate the suspected elicitor from contextual contributors and mechanism hypotheses.
Causal confidence
Record candidate cofactors and the evidence supporting trigger or mechanism assignments; preserve an unresolved cause when investigation is incomplete.
- Were exercise, alcohol, intercurrent illness or concurrent medicines present, and what supports a contributing role in this episode? provenance
- What evidence supports the attributed trigger and mechanism, and what investigation remains necessary before calling the episode idiopathic? boundary
Severity and course Represent organ compromise and its evolution across the episode.
A diagnostic label alone cannot indicate current danger, response or whether symptoms have returned.
Organ compromise
Track clinically meaningful manifestations and physiological trends.
Current and peak severity
Keep current status, worst observed status and any formal severity grade distinct, with the grading framework identified.
- What are the current and worst recorded airway, respiratory and circulatory findings, interpreted against age and baseline? measurement
- Which severity framework was used, and were observations obtained before or after treatment? provenance
Persistence and recurrence
Describe the temporal course without prematurely assigning a recurrence subtype.
Resolution and return
Record symptom resolution, any symptom-free interval and renewed symptoms alongside possible continued or repeated exposure.
- When did each manifestation resolve or return, and was complete resolution actually observed? measurement
- Under the chosen definition, does renewed illness represent a biphasic reaction, persistent illness or a new exposure-associated episode? boundary
Emergency response Connect suspected anaphylaxis to emergency actions and assess their execution and effects.
The model must support time-sensitive escalation while leaving treatment authority and detailed regimens with applicable clinical protocols.
Initial response
Capture recognition, emergency activation and first-line treatment.
Recognition-to-treatment
Intramuscular adrenaline is first-line treatment; record emergency activation and administration timing without making laboratory confirmation a prerequisite. [RCUK guideline](https://www.resus.org.uk/media/337/download)
- When was anaphylaxis suspected, when was emergency help activated and when was adrenaline administered? measurement
- Which local protocol and responder role govern immediate treatment, positioning and transfer in this setting? action
Response and escalation
Connect reassessment to further qualified clinical intervention.
Ongoing compromise
Track persistent airway, breathing or circulation problems after treatment and identify protocol-defined escalation needs. Antihistamines do not replace adrenaline for these problems. [RCUK guideline](https://www.resus.org.uk/media/337/download)
- Which manifestations persist or worsen after each intervention, and when were they reassessed? measurement
- Does the response meet the applicable refractory-anaphylaxis criteria, and which qualified team must take over? action
Investigation and future protection Carry episode evidence into diagnostic review and a documented plan for future exposure.
Acute improvement does not settle causation or complete the work needed to reduce harm from another episode.
Diagnostic evidence
Preserve the provenance and interpretation limits of episode-related investigations.
Laboratory and specialist review
Connect acute and baseline samples, subsequent allergy investigations and specialist conclusions to the original episode rather than replacing its clinical record.
- What samples were obtained, at what intervals from onset and resolution, and how were results interpreted using the relevant assay and guideline? measurement
- Which specialist conclusions support or revise the episode diagnosis and trigger attribution, and on what evidence? provenance
Observation and preparedness
Record the rationale for disposition and completion of episode-linked prevention tasks.
Disposition and emergency plan
Document a risk-based observation decision, referral and personalised emergency preparedness, including prescribed rescue medication and training where indicated. [RCUK guideline](https://www.resus.org.uk/media/337/download)
- What episode features, treatment response and access to emergency care support the chosen observation and discharge plan? action
- Who will complete trigger review, avoidance advice, rescue-medication assessment and practical emergency-plan training? action
Evidence and external alignment What the world already says about this thing, gathered so the model can be checked against it.
A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.
Reported evidence
Findings from the breadth pass, kept separate from the structural claims.
Check these first
Recalled without web access and unsourced; every item is a lead to verify.
- This describes the clinical condition; no narrower registry sense was supplied.
- The kinds mix trigger categories with a clinical course category and are not mutually exclusive.
- Guideline editions, diagnostic criteria and jurisdiction-specific coding should be checked; these statements are recalled rather than source-verified.
- Which of these check these first hold for the sense of anaphylaxis this model covers, and on what evidence? provenance
Kinds and varieties
Recalled without web access and unsourced; every item is a lead to verify.
- Food-induced anaphylaxis
- Drug-induced anaphylaxis
- Insect-venom-induced anaphylaxis
- Exercise-induced anaphylaxis, including food-dependent exercise-induced anaphylaxis
- Idiopathic anaphylaxis
- Biphasic anaphylaxis
- Which of these kinds and varieties hold for the sense of anaphylaxis this model covers, and on what evidence? provenance
Identifiers and schemes
Recalled without web access and unsourced; every item is a lead to verify.
- ICD-10 - T78.2 - Anaphylactic shock, unspecified; this is not a universal code for every anaphylaxis presentation, and trigger-specific categories also exist.
- Which of these identifiers and schemes hold for the sense of anaphylaxis this model covers, and on what evidence? provenance
Standards and regulation
Recalled without web access and unsourced; every item is a lead to verify.
- World Allergy Organization anaphylaxis guidance: clinical recognition, diagnostic criteria and management.
- European Academy of Allergy and Clinical Immunology anaphylaxis guideline: diagnosis, treatment and prevention.
- Resuscitation Council UK guidance on emergency treatment of anaphylaxis.
- Which of these standards and regulation hold for the sense of anaphylaxis this model covers, and on what evidence? provenance
Real-world use
Recalled without web access and unsourced; every item is a lead to verify.
- Clinical recognition of a medical emergency requiring prompt intramuscular adrenaline, also called epinephrine.
- Allergy investigation to identify triggers and relevant cofactors.
- Individual emergency action plans and adrenaline auto-injector training.
- Documentation of severe hypersensitivity reactions in medical records and drug-safety reporting.
- Risk assessment for trigger avoidance and, where appropriate, venom immunotherapy.
- Which of these real-world use hold for the sense of anaphylaxis this model covers, and on what evidence? provenance
Failure modes and hazards
Recalled without web access and unsourced; every item is a lead to verify.
- Delayed recognition because hives or other skin findings are absent.
- Progression to airway obstruction, respiratory failure, circulatory collapse or cardiac arrest.
- Delayed adrenaline administration or reliance on antihistamines as a substitute.
- Recurrence after apparent resolution without further exposure, termed a biphasic reaction.
- A normal serum tryptase result being incorrectly used to exclude anaphylaxis.
- Which of these failure modes and hazards hold for the sense of anaphylaxis this model covers, and on what evidence? provenance
Regional variation
Recalled without web access and unsourced; every item is a lead to verify.
- Adrenaline and epinephrine are regional names for the same medicine.
- Auto-injector availability, emergency-care access and prescribing arrangements vary between countries.
- Diagnostic coding and observation recommendations differ between national systems and guidelines.
- Which of these regional variation hold for the sense of anaphylaxis this model covers, and on what evidence? provenance
Neighbouring kinds and how to tell them apart
Recalled without web access and unsourced; every item is a lead to verify.
- Anaphylactic shock - Anaphylactic shock is anaphylaxis with circulatory failure; anaphylaxis does not require shock.
- Urticaria - Isolated hives do not establish anaphylaxis; airway, breathing, circulatory or qualifying multisystem involvement distinguishes it.
- Angioedema - Angioedema is deeper tissue swelling that may occur within anaphylaxis or independently, including through bradykinin-mediated mechanisms.
- Asthma exacerbation - Asthma can cause bronchospasm without a systemic hypersensitivity reaction; exposure history and accompanying findings help distinguish it.
- Vasovagal syncope - Vasovagal syncope causes reflex fainting, often with pallor and bradycardia, rather than systemic hypersensitivity.
- Which of these neighbouring kinds and how to tell them apart hold for the sense of anaphylaxis this model covers, and on what evidence? provenance
What the second pass must settle
- Which diagnostic frameworks should this catalogue support, and how should disagreements about gastrointestinal or isolated respiratory presentations be represented?
- Which severity, refractory-reaction and biphasic-reaction definitions should be adopted across community, emergency and perioperative settings?
- What age-specific and baseline-relative physiological thresholds should populate implementation rules, and who maintains their clinical validation?
- How should the model represent uncertainty in trigger attribution when exposure history, sensitisation tests and specialist conclusions disagree?
- Which jurisdiction-specific observation, referral and rescue-medication protocols should agents use, and how will their versions and review dates be maintained?