The approach to allergic reactions in Emergency Department

Abstract

Background. Moldova’s Institute of Emergency Medicine is adept at treating diverse patient cases, however managing allergic reactions falls outside its usual scope, resulting in variable approaches in treatment. Objective of the study. The current study aims to show case different approaches for management of allergic reactions in the emergency department in the Republic of Moldova. Material and methods. We conducted an analysis of medical records from 172 self-presenting patients at the Emergency Department (ED) in the Republic of Moldova in 2023.These patients were diagnosed with ICD 10 T78.4 (Other and unspecified allergy). Comprehensive clinical data was systematically collected and analyzed. Results. Following comprehensive analysis, the gender-based admission ratio revealed a prevalence of 113 females to 59 males. Admissions reached a peak in August, whereas both April and February exhibited a lower prevalence. Treatment regimens varied among patients, including administration of Adrenaline as well as antihistamines. These treatments adhere to standard protocols for allergic reactions; particularly type 1 hypersensitivities, characterized by histamine release, which may precipitate hypotension and shock. Deviations from the standard treatment algorithms, like Dexamethasone, was observed. Dexamethasone is not effective for acute allergic complications due to its mechanism and onset of action. However, it can be used to prevent late phase allergic reactions and to mitigate inflammatory symptoms. Conclusion. Treatment approaches for allergies and associated complications exhibit diversity in the DMU. Antihistamines and adrenaline are commonly regarded as primary treatment modalities, representing the gold standard. Although Dexamethasone has been administered on multiple occasions, its efficacy in managing acute allergic reactions is limited.