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Anaesthesia, Surgery and Life-threatening Allergic Reactions

The launch of the Royal College of Anaesthetists’ 6th National Audit Project (NAP6) Report: Perioperative Anaphylaxis          


Allergy UK, the leading patient charity for people living with allergic disease and their families, welcomes the 6th National Audit Report of the Royal College of Anaesthetists. This Report is the result of an extensive investigation into perioperative anaphylaxis in the UK and highlights risk factors and recommendations for some of the 3.5 million people anaesthetised every year, which until now, has not been fully investigated in such depth.


Amena Warner, Head of Clinical Services at Allergy UK, was a member of the NAP6 Steering and Case Review Panel and worked with John Hitchman (from the lay committee of the Royal College of Anaesthetists) on the patient experience chapter of the Report. She says:

“What is clear from this NAP6 is the dedication and determination to investigate these life-threatening reactions and examine where improvements could be made. There is a particular need for clear communication with patients who have suffered life-threatening perioperative anaphylaxis about what has happened to them, what may have caused this reaction and how it will be investigated. A person may not be aware that this has happened if they were under anaesthesia, so it is important that they are provided with an explanation and information they can understand, are clearly advised of any immediate risks, such as from a suspected antibiotic allergy, and are referred for ongoing investigation.


Clinical documentation and detailed patient information is key and we recognise that the issue of allergy can be complex one with patients themselves not always clear or informed about their allergies.  This puts the responsibility on clinicians to spend more time exploring their patient’s allergy history, asking about previous reactions around anaesthesia or surgery and discussing risk. An explanation of this risk, alongside other risks associated with anaesthesia and surgery, could provide a valuable prompt for a wider conversation about a patient’s particular concerns about possible reactions.


This Report marks a major step forward in provision of information for anaesthetists on this life threatening perioperative complication, and it highlights the particular challenges both clinicians and their patients face in mitigating the risk of perioperative anaphylaxis. 

Allergy UK will be addressing this subject through their information Factsheets that both the public and healthcare professionals can freely access and download and we will start putting this together from key elements of this Report. In the meantime, help or advice on this subject is available through our Helpline on 01322 619898 or via our website”

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