Résumé
Background: anaphylaxis is a severe life-threatening systemic hypersensitivity reaction generally first seen by emergency doctors, general practitioners or pediatricians. The aim of this study is to review the evidence-based data related to the management of anaphylaxis at the pre-hospital and emergency settings in order to possibly propose strategies for prevention and optimization of health care pathways.Methods: a systematic review based on five academic databases with qualitative and quantitative analysis of the characteristics of the articles and clinical data was conducted. Results: 8 out of 1278 identified articles were included for analysis, from 3 continents and 3 specialties: allergology, pediatrics and emergency department. Articles insisted on difficulties with diagnosis, especially in pediatric age, and on the delay or under-use of adrenaline. According to the age categories, specific phenotypes at-risk were identified. No studies mentioned the dosage of serum tryptase. Referral to allergist was mentioned in 3 of the 8 documents. Conclusion: evidence-based data provided highlights of the key issues related to the management of anaphylaxis, such as the difficulties with the diagnosis, lack of collections of samples for tryptase measurement and timely use of adrenaline. More than underlining the need for optimization of heath care pathways for anaphylactic patients, we were able to identify patients at risk to tailor personalized care and suggest questionnaires addressed to health professionals dealing with anaphylaxis in order to improve the quality of care for these patients.