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Ann Allergy Asthma Immunol. 2007 Jun;98(6):519-23.

SAFE: a multidisciplinary approach to anaphylaxis education in the emergency department.

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Division of Allergy and Immunology, Department of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee, USA.



Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Allergists and emergency department (ED) physicians recognize the need for multidisciplinary efforts to increase public awareness of anaphylaxis, improve patient education, and enhance emergency and long-term management for the millions of Americans at risk for anaphylactic reactions.


To provide an overview of the scientific literature documenting inconsistencies and limitations in the management of anaphylaxis in the ED, to highlight the need to enhance ED discharge instructions and patient education materials, and to introduce the SAFE system, an aid to improve the ongoing management and avoidance of factors that contribute to anaphylaxis.


An expert panel of allergists and ED physicians was convened by the American College of Allergy, Asthma and Immunology and the American College of Emergency Physicians to develop recommendations for educational materials on anaphylaxis for ED personnel and patients.


The panel developed the acronym SAFE, a mnemonic device to remind physicians of the 4 basic action steps suggested for the care of a patient with anaphylaxis: (1) Seek support, (2) Allergen identification and avoidance, (3) Follow-up for specialty care, and (4) Epinephrine for emergencies.


The SAFE system is designed as a tool to raise awareness of anaphylaxis and its treatments among individuals at risk and the ED personnel charged with their care. Future studies need to examine the impact of the SAFE system in decreasing the morbidity and mortality rates associated with anaphylaxis and other severe allergic reactions.

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