Step 1 of 3 33% Screening for eligibilityDid the anaphylaxis present between x/x/2026 00:00 and x/x/2027 23:59(Required) Yes No Please log the anaphylaxis in the NAP8 registry at time of presentation. An automatic alert will be sent at 6 months to review the case notes; log in and record if allergen testing is positive for any components of the regional anaesthesia technique usedDid the patient develop life threatening anaphylaxis with: 1. Unexpected severe hypotension AND/OR 2. Severe bronchospasm AND/OR Swelling with actual or potential airway compromise OR 4. Cardiac arrest?(Required) Yes No Was the anaphylaxis confirmed to be secondary to: 1. Local anaesthetic in RA technique OR 2. Another drug administered during central neuraxial or peripheral nerve block OR 3. Skin preparation solutions for RA performance?(Required) Yes No Was anaphylaxis confirmed by allergen testing to be secondary to any drug used for sedation or general anaesthesia in a patient (who had a concurrent central neuraxial or peripheral nerve block)?(Required) Yes No Unsure Was the anaphylaxis agreed by the local multidisciplinary team to be secondary to another cause unrelated to the peripheral nerve block?(Required) Yes No Unsure Sorry, this case is not eligible to report. Anaphylaxis reportWas there any other relevant past medical history? Previous anaphylaxis Angioedema Urticaria Eczema Hayfever Food allergy Cause of previous anaphylaxis / known allergenOther relevant drug history pre operatively ACE inhibitor Beta blocker Presentation – Airway Laryngeal oedema Presentation – Breathing Bronchospasm Cyanosis Oxygen desaturation Reduced / absent capnography trace Change in peak airway pressure (if ventilated)Max peak airway pressurePresentation – Cardiac Hypotension Bradycardia Tachycardia Arrhythmia Cardiac arrest Lowest BPLowest HRHighest HRRhythmHighest ratePresentation – Other Swelling / Oedema – non laryngeal Urticaria Flushing / Non urticarial rash Itch Abdominal pain Patient “feeling unwell” Nausea / vomiting Diarrhoea What grade was the anaphylaxis? 3 4 5 3: Life-threatening Unexpected severe hypotension, and or severe bronchospasm, and or swelling with actual or potential airway compromise +/− Grade 1 features (rash, erythema, swelling) 4: Life-threatening: Fulfilling indications for cardiopulmonary resuscitation 5: FatalWhat was the first feature that alerted the anaesthetist that this was possibly anaphylaxis? First Choice function getCheckedValues() { const items = SOURCE_FIELDS.flatMap(function(fieldId) { const field = document.getElementById(fieldId); if (!field) { console.warn(‘Source field not found:’, fieldId); return []; } return Array.from(field.querySelectorAll(‘input[type=”checkbox”]:checked’)).map(function(cb) { var label = document.querySelector(‘label[for=”‘ + cb.id + ‘”]’); return { value: cb.value, label: label ? label.textContent.trim() : cb.value }; }); }); console.log(‘All checked items:’, items); return items; }Were other differential diagoses considered? Please outline.Drugs administered in initial management Adrenaline IV Adrenaline IM Vasopressors Glucagon Glycopyrolate Atropine Salbutamol IV Salbutamol nebulised / inhaled Magnesium sulphate Aminophylline Antihistamine Steroid Other Did the patient require tracheal intubation? Yes No Already intubated Was blood taken for mast cell tryptase? Yes No Please provide mast cell resultsWas the patient referred to an allergy clinic? Yes No TimelinePlease prepare a timeline detailing each drug, fluid, blood product and sterilisation agent administered in the 120 minutes prior to anaphylaxis developing. Please use the first direct procedural contact by the anaesthetist or PAA as TIME ZERO (e.g. either induction of general anaesthesia or commencement of a regional anaesthetic technique) and label this as such. Please consider and include where appropriate all the following agents (doses are not required). Skin cleansing agent for block All local anaesthetics and additives used for regional anaesthetic or surgical local infiltration Pre-medication Induction agent Opioids Other multimodal analgesics Muscle relaxant Anti-emetic Volatile agent Antimicrobial Reversal agent IV colloid Blood products Dye Skin cleansing agent for surgical procedure Please finish by documenting the time of the anaphylaxis in relation to time zero ListTime (start 00:00)EventProduct administeredRoute given Add Remove
