Last update: 19/1/2026
It is the responsibility of all clinical staff to be aware of and minimise the risk of serious adverse events and should they occur, to be competent to recognise and instigate appropriate first aid treatment.
ACE & Dr Tim Pearce protocols will be followed in the event of a complication, and are accessible to all clinical staff in hard copy format for reference.
Possible serious adverse events
· Anaphylaxis
· Pending necrosis
Minimise Risk
All patients will complete medical history which shall include information about allergies.
Patients having an anaphylactic reaction in any setting should expect the following as a minimum:
· Recognition that they are seriously unwell.
· An early call for help.
· Initial assessment and treatments based on an ABCDE* approach.
· Adrenaline therapy if indicated.
· Investigation and follow-up by an allergy specialist.
Resuscitation Council
· All clinical staff will have anaphylaxis training updates as appropriate (annual/every two years)
· All clinical staff will be familiar with Resuscitation Council Guidelines
· Resuscitation Council Algorithm will be displayed in clinical settings
· Resuscitation kit will be located in (accessible location)
· Clinicians will dial 999 immediately/instruct clinic staff to dial 999 immediately
· Two Adrenaline (epinephrine) ampoules 1, or x2 auto injectors such as Emerade® auto injector with adult dose
· Four 23 guage Needles for IM injection
· Four Graduated 1ml Syringes
· Laerdal or equivalent adult mask
· Drugs should be checked regularly for expiry dates
It is recommended practitioners download and print for display and easy referral, the Resuscitation Council Algorithm; https://www.resus.org.uk/library/additional-guidance/guidance-anaphylaxis
As a life threatening event requiring hospital treatment, anaphylaxis is a reportable event. If related to a prescription only medicine, it should be reported using the MHRA Yellow card Scheme, if to a dermal filler (a medical device) then reporting button as directed on MHRA home page;
http://www.mhra.gov.uk/Safetyinformation/Reportingsafetyproblems/Devices/index.htm.
Of course, manufacturers should be notified also.
Minimise Risk
· Be familiar with related anatomy of arteries and veins
· Be aware of high risk zones for treatment
· Be familiar with signs and symptoms of vascular compromise
· Use blunt tip cannula as appropriate
· Draw back when possible, before injecting with a needle
· Inject slowly
· Observe patient for pain
· Observe skin for signs of blanching
In the event of vascular compromise:
· Stop injecting immediately, if blanching observed
· Provide an explanation to the patient of what has happened.
· Instigate immediate measures to restore circulation. These may include;
· Vigorous massage
· Injection with Hyaluronidase as per protocol
· Application of heat
· If circulation restored patient should be observed and contact maintained until recovery
