Standard operating procedure

Emergency Drugs & Anaphylaxis Procedure

How [Organisation Name] holds, checks and uses emergency medicines and equipment, and recognises and treats anaphylaxis in line with Resuscitation Council UK guidance

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  • Editable Microsoft Word (.docx)
  • Mapped to the CQC standards
  • Optional 3-monthly updates

What's inside

This standard operating procedure is fully drafted and structured, ready to brand and complete for your service. It covers:

  • 1. Purpose
  • 2. Scope
  • 3. Definitions and abbreviations
  • 4. Responsibilities
  • 5. Emergency drugs and equipment held
  • 6. Procedure
  • 7. Intramuscular adrenaline 1:1000 dosing by age
  • 8. After the event
  • 9. Records
  • 10. Related documents
  • 11. Review and version control
  • 12. Disclaimer

Legislation & standards it maps to

  • Resuscitation Council UK, Emergency treatment of anaphylactic reactions: Guidelines for healthcare providers (2021)
  • Resuscitation Council UK, Quality standards for cardiopulmonary resuscitation practice and training: Primary Care (current edition)
  • Human Medicines Regulations 2012 (SI 2012/1916, as amended) - holding, supply and administration of medicines, including administration of adrenaline in an emergency
  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Regulation 12 (Safe care and treatment)
  • Medicines and Healthcare products Regulatory Agency (MHRA) Yellow Card scheme for reporting suspected adverse drug reactions
  • National Institute for Health and Care Excellence, Anaphylaxis: assessment and referral after emergency treatment, NICE guideline CG134 (2011, updated)
  • Data Protection Act 2018 and the UK General Data Protection Regulation - confidentiality and retention of records
  • Records Management Code of Practice - retention schedules for health and care records

Who it applies to

All GP partners, salaried and locum GPs, advanced nurse practitioners, practice and treatment-room nurses, healthcare assistants, clinical pharmacists, paramedics and any other clinical staff who treat patients on the premises, together with the registered manager, practice manager and reception staff at [Organisation Name]

Glossary

Plain-English explanations of the technical terms and legislation used in this document.

Adjunctive treatment
Extra treatment given to support the main treatment, never instead of it - here, medicines given after adrenaline in anaphylaxis.
Adrenaline (epinephrine)
The life-saving medicine injected into a muscle to reverse a severe allergic reaction; 1:1000 strength is used for this.
Adverse drug reaction
An unwanted or harmful response to a medicine given at a normal dose.
Airway adjunct
A simple device, such as an oropharyngeal airway, used to help keep a patient's airway open.
Anaphylaxis
A severe, life-threatening allergic reaction needing immediate emergency treatment.
Angioedema
Rapid swelling beneath the skin, often of the lips, face, throat or tongue, which can block breathing.
Anterolateral thigh
The outer middle part of the thigh, the recommended site for injecting adrenaline into the muscle.
Automated external defibrillator (AED)
A portable device that checks the heart's rhythm and, if needed, delivers an electric shock to restart a normal beat.
Bag-valve-mask (BVM)
A hand-held device squeezed to push air into the lungs of a patient who is not breathing properly.
Basic life support (BLS)
The first-aid skills, including chest compressions and rescue breaths, used to keep someone alive until expert help arrives.
Biphasic reaction
A second wave of an allergic reaction that returns hours after the first has settled, which is why patients are observed in hospital.
Cardiac arrest
When the heart suddenly stops pumping blood, requiring immediate resuscitation.
Cardiopulmonary resuscitation (CPR)
Chest compressions and rescue breaths given when a person stops breathing normally or has no pulse.
Care Quality Commission (CQC)
The independent regulator of health and social care services in England.
Controlled drug
A medicine whose supply, storage and records are tightly restricted by law because of its potential for misuse.
Corticosteroid
An anti-inflammatory medicine, such as hydrocortisone, sometimes given to support recovery after a severe allergic reaction.
Cyanosis
A bluish colour of the skin or lips caused by low oxygen in the blood.
Data Protection Act 2018
The UK law that governs how organisations handle and protect people's personal information.
Defibrillation
Delivering a controlled electric shock to the heart to restore a normal rhythm during cardiac arrest.
Glucagon
A medicine that raises blood sugar quickly, used to treat dangerously low blood sugar.
Glyceryl trinitrate (GTN)
A spray or tablet that widens blood vessels, used for suspected heart-related chest pain.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
The regulations setting out the fundamental standards that registered care providers must meet, enforced by the Care Quality Commission.
Human Medicines Regulations 2012
The main UK law controlling how medicines are licensed, supplied and given, including emergency adrenaline.
Hypersensitivity reaction
An exaggerated immune response to a substance the body has reacted badly to, ranging from a mild rash to anaphylaxis.
Hypoglycaemia
A dangerously low level of sugar in the blood, which can cause confusion, collapse or seizures.
Hypoxia
A shortage of oxygen reaching the body's tissues.
Infection prevention and control (IPC)
The measures used to stop infection spreading between patients, staff and visitors.
Intramuscular (IM)
An injection given into a muscle; in anaphylaxis adrenaline is injected into the outer middle of the thigh.
Intravenous (IV)
Given directly into a vein; intravenous adrenaline is for specialist use only, not routine general practice.
Medicines and Healthcare products Regulatory Agency (MHRA)
The UK body that regulates medicines and medical devices and runs the Yellow Card scheme.
Mucosal changes
Visible changes, such as swelling or redness, to the moist linings of the mouth, eyes or throat.
Myocardial infarction
A heart attack, caused by a blocked blood supply to part of the heart muscle.
National Institute for Health and Care Excellence (NICE)
The national body that produces evidence-based guidance on treatments and care for use across health and care services.
Nebuliser
A machine that turns liquid medicine into a fine mist to be breathed into the lungs.
Nominated lead
The named member of staff given day-to-day responsibility for maintaining and checking the emergency drugs and equipment.
Oropharyngeal airway
A curved plastic tube placed in the mouth to help keep an unconscious patient's airway open.
Oxygen saturation
A measure of how much oxygen the blood is carrying, usually shown as a percentage.
Positive-pressure ventilation
Pushing air or oxygen into the lungs, for example with a bag-valve-mask, when a patient cannot breathe adequately alone.
Records Management Code of Practice
National guidance setting out how long health and care records should be kept and how they should be managed.
Recovery position
Laying an unconscious but breathing patient on their side to keep the airway clear.
Registered Manager
The person registered with the regulator as responsible for the day-to-day running of a service.
Resuscitation Council UK
The UK organisation that sets the national guidelines for resuscitation and the emergency treatment of anaphylaxis.
Salbutamol
A reliever medicine, usually inhaled, that opens the airways in asthma or wheezing.
Seizure
A sudden burst of uncontrolled electrical activity in the brain causing shaking, stiffening or loss of awareness.
Sharps
Needles, blades and other items that can cut or puncture the skin.
Single assessment framework
The structure the regulator uses to judge a service, built around quality statements and five key questions (safe, effective, caring, responsive, well-led).
Standard Operating Procedure (SOP)
A written, step-by-step instruction setting out exactly how a particular task is to be carried out.
Stridor
A high-pitched sound when breathing in, caused by a narrowed or blocked upper airway.
UK General Data Protection Regulation (UK GDPR)
The UK's main data-protection law governing how personal information is collected and used.
Urticaria
A raised, itchy rash (hives), often a sign of an allergic reaction.
Yellow Card scheme
The Medicines and Healthcare products Regulatory Agency system for reporting suspected side effects of medicines or faulty devices.

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