Anaphylaxis: evidence-based long-term risk reduction in the community.

Anaphylaxis occurs frequently in the community, and it can be fatal in community settings. Risk assessment and risk reduction should ideally be coordinated by an allergy/immunology specialist and focus on: (1) prevention of subsequent anaphylaxis episodes, (2) emergency preparedness, and (3) anaphylaxis education. Preventive strategies should include trigger avoidance, specific preventive measures, and optimal management of comorbidities. Despite best efforts to avoid anaphylaxis triggers they can be encountered inadvertently, and anaphylaxis episodes can and do recur. Risk reduction therefore also focuses on emergency preparedness: carrying self-injectable epinephrine, having a personalized Anaphylaxis Emergency Action Plan, and wearing accurate medical identification. Anaphylaxis education should involve not only at-risk individuals and their families, but also health care professionals and the general public.