First aid for anaphylaxis: practical and organizational aspects

Considering the rapid, often unpredictable and unfavorable course of anaphylaxis, early recognition of the signs of this emergency and immediate provision of first aid (FA) by the victims themselves or by the witnesses before the arrival of emergency medical services are of exceptional and sometimes of vital importance. Trends towards an increase in the incidence of anaphylaxis and the actual increase in the number of hospitalizations due to complications of severe allergic reactions indicate the high relevance of the problem and the need to establish a reliable organizational basis to ensure the widespread practice of providing FA for anaphylaxis in the Russian Federation. This research aimed to review current international and national guidelines on the provision of FA for anaphylaxis and to identify possible areas for improving the organization of FA for anaphylaxis in Russia. According to the authors’ opinion, the application of evidence-based provisions presented in the current FA guidelines to real-life FA practice can significantly improve outcomes in anaphylaxis, but at the same time requires some basic organizational changes. The priority directions in organizing the provision of FA for anaphylaxis in the Russian Federation are the development and approval by the Ministry of Health of Russia of a uniform procedure for the provision of FA for anaphylaxis, including a list of measures for the provision of FA and the sequence of their application; creating conditions for standardized training of the population in the principles and methods of providing FA; and ensuring the general availability of epinephrine in the form of autoinjectors as a first-line treatment to prevent life-threatening complications of anaphylaxis.