Preventative Healthcare

Preventive healthcare and screening are essential components of the Australian healthcare system, aimed at reducing the incidence of disease, detecting illness early, managing conditions effectively, and promoting a healthy lifestyle. The Australian government, along with state and territory health departments, provides a range of free or subsidized screening programs and preventive health initiatives. Here’s a summary of some key components:

  1. National Immunisation Program (NIP)
    • The NIP provides free vaccines to eligible people to help control preventable diseases.
    • Key vaccinations include those against influenza, measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis, polio, and human papillomavirus (HPV).
    • Vaccination schedules are provided for infants, children, teenagers, and adults, including special groups like pregnant women and older Australians.
    • More details on vaccination are found below.
  2. National Cervical Screening Program (25-74 every 5 years)
    • Replacing the Pap test, the Cervical Screening Test is more effective at preventing cervical cancers and is recommended every five years for women with a cervix aged 25 to 74.
    • The test looks for the presence of HPV, which can lead to cervical cancer if left untreated.
  3. BreastScreen Australia (50-74 every 2 years)
    • This program targets women aged 50 to 74 for free mammograms every 2 years to detect breast cancer early.
    • Although the program focuses on this age group, women aged 40 to 49 and over 74 are also eligible for free mammograms.
    • Early detection significantly improves treatment outcomes.
  4. National Bowel Cancer Screening Program (50-74 every 2 years)
    • Bowel cancer screening is crucial since bowel cancer often has no symptoms until it’s more advanced.
    • The National Bowel Cancer Screening Program (NBCSP) invites all people aged 50 to 74 to screen for colorectal cancer every two years.
    • The FOBT kits provided are a non-invasive way to detect early signs of bowel cancer.
    • Positive results should be followed up with a colonoscopy.
  5. Aboriginal and Torres Strait Islander Peoples’ Health (Children and 18+ for CVD, CKD, annual)
    • Initiatives here aim to improve access to culturally appropriate health care.
    • This includes regular health check-ups, management of chronic conditions, maternal and child health services, and community-led health promotion to address the higher burden of disease in Indigenous communities.
  6. Pregnancy and Early Childhood
    • The Australian healthcare system provides various check-ups during pregnancy, birth, and the postnatal period, as well as developmental checks for children.
    • These include hearing tests, oral health assessments, and immunizations, along with advice on nutrition and safe sleeping practices.
  7. Cardiovascular Risk Assessment (45+ every 2 years; 18+ ATSI)
    • Regular cardiovascular risk assessments are aimed at preventing heart disease and stroke.
    • GPs use tools that estimate a patient’s risk of a cardiovascular event in the next five years based on factors like age, sex, smoking status, blood pressure, and cholesterol levels.
  8. Diabetes Screening (40-49; 18+ ATSI)
    • For diabetes, screening recommendations are for those at high risk, including people over 40, those with a family history of diabetes, high blood pressure, or who are overweight.
    • The AUSDRISK tool is used for screening non-ATSI.
    • ATSI are screened yearly from 18 due to higher risk and this screening is blood tests (fasting BSL, HbA1c). In addition BP/ACR/eGFR are done to look for CKD
  9. Mental Health
    • Mental health services include screening for depression and anxiety, especially in at-risk groups such as postpartum women and adolescents.
    • Access to psychological services can be facilitated by GPs through mental health care plans, which offer subsidized sessions with mental health professionals.
  10. Lifestyle Risk Factors
    • Screening for lifestyle risk factors is part of routine GP visits.
    • It involves discussing and assessing behaviors like smoking, alcohol consumption, diet, and physical activity levels, with interventions offered as needed.
    • SNAP-O (Smoking, Nutrition, Alchohol, Physical Activity, Obesity)
  11. Osteoporosis Screening (70)
    • Screening for osteoporosis includes assessing risk factors and, when appropriate, conducting bone density scans.
    • Women and men over 70, particularly those with risk factors like low body weight or a history of fractures, are candidates for screening.
  12. Skin Cancer Checks
    1. Australia has one of the highest rates of skin cancer in the world.
    2. Regular self-checks and professional skin examinations are recommended, particularly for those with fair skin, a history of sunburns, or a family history of skin cancer.
  13. Healthy Kids Check
    • This comprehensive health assessment for children around the age of four checks physical health, general well-being, and development to ensure children are healthy, fit, and ready to learn when they start school.
  14. Flu Vaccination
    • Annual flu vaccination is provided for free to certain high-risk groups, including the
      • elderly (>=65 years old)
      • ATSI (>=5 years old)
      • pregnant women @ 20-32/40, and
      • those with chronic health conditions.
  15. Work Health Assessments
    1. These assessments are tailored to the risks associated with specific jobs, aiming to prevent occupational illnesses and injuries.
    2. They can include hearing tests, skin checks, and respiratory assessments, depending on the nature of the work.
  16. Age-Specific Assessments
    1. For older Australians, there are specific health assessments available to help manage complex health needs and promote independence and well-being.
    2. MBS Item Numbers: 701, 703, 705, 707 and 715 (ATSI)

Patient Information and Education

Providing educational resources about preventive health is a key strategy. This includes public health campaigns on topics like smoking cessation, healthy eating, and the importance of physical activity.

General Practice Involvement

GPs are pivotal in the preventive health landscape. They not only perform many of the screenings but also provide personalized advice on lifestyle modifications and vaccinations, and they act as a gateway to other health services.

All these programs are designed with the aim of early detection and intervention to reduce the burden of disease, improve health outcomes, and increase the longevity and quality of life for Australians. They are reviewed and updated as new evidence emerges, ensuring that the strategies employed are based on the best available evidence.

Vaccination

ATSI Extra Vaccines

  1. BCG @ birth
  2. Meningococcal B @ 2, 4, 12 months (+6 months for at risk)
  3. Extra pneumococcal 13V @ 6/12
  4. Extra pneumococcal 23V at 4 years and 9 years
  5. Influenza yearly indefinitely for > 6/12
  6. Hep A @ 18/12 and 4 years
  7. Pneumococcal @ 50 (13V), 51 (23V), 56 (23V)
  8. Shingrix early @ 50 (2 doses 2-6 months apart)

At Risk Extra Vaccines

  1. 6 months Pneumococcal 13V  (Prevenar 13)
  2. 4, 9 years Pneumococcal 23V (at risk) (Pneumovax 23)
  3. 5 years ongoing Influenza

Birth

  • Hep B (Energix B paediatric)
  • TB (live) (BCG)

2 months

  • Diptheria, Tetanus, Pertussis, Hep B, Hib, Polio (Infranrix Hexa, Vaxelis)
  • Pneumococcal 13V (Prevenar 13)
  • Rotavirus (live) (Rotrix)
  • Meningococcal B (Bexsero)

4 months (same as 2 months)

  • Diptheria, Tetanus, Pertussis, Hep B, Hib, Polio (Infranrix Hexa, Vaxelis)
  • Pneumococcal 13V (Prevenar 13)
  • Rotavirus (live) (Rotrix)
  • Meningococcal B (Bexsero)

6 months

  • Diptheria, Tetanus, Pertussis, Hep B, Hib, Polio (Infranrix Hexa, Vaxelis)
  • Influenza (annual)
  • Pneumococcal 13V  (at risk) (Prevenar 13)
  • Pneumococcal 13V (Prevenar 13)
  • Meningococcal B (at risk) (Bexsero)

7 months

  • Influenza (2nd dose)

12 months

  • Measles, Mumps, Rubella (Priorix)
  • Pneumococcal 13V (Prevenar 13)
  • Meningococcal ACWY (Nimenrix)
  • Meningococcal B (Bexsero)

18 months

  • Measles, Mumps, Rubella, Varicella (Priorix-tetra)
  • Diptheria, Tetanus, Pertussis (DTPa) (Infranrix)
  • Hib (Act HIB)
  • Influenza (annual)
  • Hepatitis A (NT,WA,SA,Qld) (Vaqta Paed)

2 1/2 years

  • Influenza

3 1/2 years

  • Influenza

4 years

  • Diptheria, Tetanus, Pertussis, Polio (Infranrix IPV)
  • Pneumococcal 23V (at risk) (Pneumovax 23)
  • Pneumococcal 23V (NT,WA,SA,Qld) (Pneumovax 23)
  • Hepatitis A (NT,WA,SA,Qld) (Vaqta Paed)

4 1/2 years

  • Influenza

> 5 years

  • Cease annual influenza in non-ATSI
  • Influenza (at risk)
  • Influenza (all ATSI)

9 years

  • Pneumococcal 23V (2nd dose) (Pneumovax 23)
  • Pneumococcal 23V (2nd dose) (Pneumovax 23)

12-13 years (Year 7)

14-16 years (Year 10)

  • Meningococcal ACWY (Nimenrix)

>50 years

  • 50 – Shingles (Shingrix) – 2 doses 2-6 months apart
  • 50 – Pneumococcal 13V (Prevenar 13) then 2-12 months later
  • 51 – Pneumococcal 23V (Pneumovax 23) then 5 years later
  • 56 – Pneumococcal 23V (Pneumovax 23)

>65 years

  • Influenza (adjuvanted) Quadrivalent (Fluad Quad) – Yearly
  • Shingles (Shingrix) – 2 doses 2-6 months apart
    • Replaces Zostavax (which was at 70)

>70 years

  • Pneumococcal 13 (Prevenar 13)

Pregnant

  • dTpa (for pertussis) @ 20-32/40 (Boostrix, Adacel)
  • Influenza @20-32/40
  • Pneumococcal (if a smoker)
  • If not immune
    1. HBV (if high risk)
    2. VZV vaccine before or after pregnancy
      1. Zostervax is live (so contraindicated)
      2. Shingrix is unknown data for pregnancy
    3. Rubella (live vaccine – before or after pregnancy)

Asplenia, hyposplenia, complement deficiency eculizumab

  • All encapsulated organism vaccines (depends on prior immunisations)
    • Pneumococcal
    • Meningococcal ACWY
    • Meningococcal B
    • Hib

Covid-19

The following people are recommended an additional 2023 COVID-19 vaccine dose if 6 months have passed since their last dose:

  • all people aged 75 years and over

The following groups may consider an additional 2023 COVID-19 vaccine dose if 6 months have passed since their last dose and after discussion with their healthcare provider:

  • all people aged 65 to 74 years.
  • people aged 18 to 64 years who have severe immunocompromise.

MSM (Men who have sex with men)

MSM should have the following vaccinations (in addition to 3/12 routine STI screening and PrEP)

  • Meningococcal B and ACWY
  • HAV
  • HBV
  • HPV

Vaccine Coverage

  • BCG
    • Birth (ATSI)
  • DTPa
    • 2, 4, 6 months (Infranrix Hexa, Vaxelis)
    • 18 months (Infranrix)
    • 4 years (Infranrix IPV)
    • 12 years (dTpa) (Boostrix)
    • Then every 10 years
    • Pregnancy @ 20-32 weeks (Boostrix)
  • HAV (Hepatitis A)
    • 18 months (Vaqta paed)
    • 4 years (Vaqta paed)
  • HBV (Hepatitis B)
    • Birth (Energix B paediatric)
    • 2, 4, 6 months (Infranrix Hexa, Vaxelis)
  • Hib (Haemophillus influenzae)
    • 2, 4, 6 months (Infranrix Hexa, Vaxelis)
    • 18 months (ACT Hib)
  • HPV (Human Papilloma Virus)
    • Single dose (Gardasil 9)
    • 3 dose schedule for immunocompromised 0, 1, 6 months
  • Influenza
    • 6 months (initial)
    • 7 months (2nd dose)
    • Annual @ 18 months, 2 1/2 years, 3 1/2 years, 4 1/2 years
    • Continue annual past 5 for at risk children
    • Continue annual past 5 for ATSI
    • Pregnancy @ 20-32 weeks
  • Meningococcal ACWY (Nimenrix)
    • 12 months
    • 14-16 years
  • Meningococcal B (Bexsero)
    • 2, 4, 12 (ATSI)
    • 6 months (ATSI at risk)
  • MMR (Measles Mumps Rubella)
    • 12 months (Priorix)
    • 18 months (Priorix Tetra)
  • Pneumococcal 13V (Prevenar 13)
    • 2 months
    • 4 months
    • 6 months (At risk)
    • 6 months (ATSI)
    • 12 months
    • 50 years (ATSI)
    • 70 years
  • Pneumococcal 23V
    • 4 years (At risk)
    • 4 years (ATSI)
    • 9 years (At risk)
    • 9 years (ATSI)
    • 51, 56 years (ATSI following 13V @ 50 years)
  • Polio
    • 2, 4, 6 months (Infranrix Hexa, Vaxelis)
    • 4 years (Infranrix IPV)
  • Rotavirus (Rotrix)
    • 2, 4 months
  • Varicella
    • 18 months (Priorix Tetra)
  • Zoster (Shingrix)
    • 50 years (ATSI)
    • 65 years
    • 2 doses 2-6 months apart

Paracetamol and Vaccination

  • Avoid Routine Pre-medication:
    • Routine prophylactic use of paracetamol is not recommended for all vaccines.
    • This is because there is some evidence suggesting that routine use might reduce the immune response to certain vaccines.
  • Paracetamol to reduce the risk of fever is not routinely recommended before during or immediately after vaccination.
  • The exception is a specific recommendation to give paracetamol prior to meningococcal B vaccine (Bexsero) in infants <2 years of age.
  • After Vaccination:
    • If a child develops a fever or appears particularly uncomfortable after vaccination, paracetamol can be used to relieve these symptoms.
    • It’s important to use the correct dose (15mg/kg) based on the child’s weight.

Fever and Vaccination

  • Babies can usually get their vaccinations even if they are feeling a little unwell, such as a runny nose or slight cold.
  • Children with high fever (38.5 °C or more) or a more serious illness, should wait until they are well to get vaccinated

Vaccine Administration

  • Almost all vaccines are administered IM.
    • IM injections are given using a 25 mm 23-25 g needle held at 90 degrees to the skin
  • 3 vaccines are administered subcutaneously (MMR, Varicella, Zostervax)
    • Subcutaneous injections are given using a 16 mm 25-27 g needle held at 45 degrees to the skin
    • This means they are injected into the fatty layer of tissue just under the skin.
    • Note these 3 s/c vaccines are all live vaccines.
      • Measles, Mumps, Rubella (Priorix only – MMR-II is s/c or IM)
      • Varicella (Priorix tetra)
      • Zoster (Zostavax only – Shigrix is IM)
  • Rotrix is an oral vaccine.

Vaccine Hesitancy

Vaccine hesitancy, the reluctance or refusal to vaccinate despite the availability of vaccines, is a complex issue influenced by a variety of factors including lack of trust, misinformation or lack of information, complacency, and convenience.

To manage vaccine hesitancy in the primary care setting in Australia (or anywhere), healthcare providers can use several strategies:

  1. Building Trust and Rapport:
    • Strong relationships between healthcare providers and patients can increase the acceptance of vaccines.
    • Be transparent, consistent, and honest in your communications.
  2. Motivational Interviewing:
    • This patient-centered counseling approach can help to explore and resolve ambivalence, by encouraging patients to talk about their concerns and helping them to arrive at their own decisions.
    • RULE mnemonic – Resist the righting reflex, Understand the patients own motivation, Listen with empathy, Empower the patient
  3. Education and Information Sharing:
    • Provide clear, concise, and accurate information about vaccines, including their benefits and potential risks.
    • Address any misconceptions or misinformation the patient may have encountered.
  4. Share Personal Experiences and Recommendations:
    • Patients often trust their doctor’s personal and professional opinions.
    • Sharing your own experiences and reinforcing your professional recommendation for vaccination can be powerful.
  5. Address Specific Concerns and Questions:
    • Each patient may have unique concerns or fears, such as side effects or the speed at which the vaccine was developed (COVID-19).
    • Address these issues directly and provide reassurances based on scientific evidence.
  6. Highlight Community Protection:
    • Explain the concept of herd immunity and how choosing to get vaccinated protects others in the community, particularly those who are vulnerable and unable to get vaccinated themselves.
  7. Reminders and Follow-ups:
    • Use system reminders for due vaccinations and follow up with patients who may be hesitant.
  8. Convenience:
    • Make the process of getting vaccinated as easy as possible.
    • This could include offering extended hours, walk-in clinics, or reminders for when vaccines are due.
  9. No Jab, No Play
    • Laws are implemented at the state/territory level and govern the conditions for enrolment in early childhood education and care services.
  10. No Jab, No Pay
    • This is the more coercive Australian government approach that withholds the Child Care Subsidy (CCS) and Family Tax Benefit Part A (FTB Part A) supplement.

Remember, it’s important to approach conversations with empathy and respect. Effective communication is key. Sometimes, vaccine hesitancy can’t be overcome in one visit, and that’s okay. The goal should be to keep the lines of communication open for ongoing dialogue.

Egg Allergy

  • All routine immunisations can be administered to children with the exception of egg based influenza vaccine.
  • The influenza, yellow fever and Q fever vaccines are the vaccines of concern for individuals with egg allergies.
    • This is because these vaccines are produced using egg-based technology, meaning they contain a small amount of egg protein.
    • Influenza (Flu) Vaccine: Historically, it was recommended that individuals with severe egg allergies avoid the flu vaccine or receive it only under medical supervision. However, more recent guidelines from The Australian Technical Advisory Group on Immunisation recommends that all people with egg allergies can receive an age-appropriate influenza vaccine. It’s recommended that individuals with a history of severe allergic reaction to the flu vaccine or to any of its components (excluding egg allergy) avoid vaccination.
    • Yellow Fever Vaccine: This is one vaccine that is still a concern for those with egg allergies. The yellow fever vaccine is cultured in eggs, resulting in a larger amount of egg protein. Individuals with a history of severe (anaphylactic) egg allergy are generally advised to avoid this vaccine.
    • Q Fever Vaccine: The Q Fever vaccine (Q-VAX®) is also cultured in hen eggs and is therefore contraindicated in people with severe egg allergies.

Finding Immunisation Records

In Australia, immunisation records can be accessed through several channels. The most comprehensive record is typically the Australian Immunisation Register (AIR), which keeps a record of all vaccines given to all people in Australia. Here are the primary sources:

  1. Australian Immunisation Register (AIR):
    • This is a national register that records vaccinations given to people of all ages in Australia.
    • Practice management software includes access to AIR for both upload and download.
    • Patients can access their own, or their child’s, immunisation history statement through their Medicare online account on myGov.
  2. My Health Record:
    • This is a secure online summary of your health information, where healthcare providers can see your health information including allergies, medicines you are taking, medical conditions you have, pathology test results like blood tests, and immunisation records.
  3. State and Territory Registers:
    • Some states and territories in Australia have their own immunisation registers, although with the advent of the AIR, many of these are being phased out.
  4. Healthcare Provider Records:
    • Healthcare providers who administered the vaccines should have records of those immunisations.
  5. Personal Health Record (Blue or Red Book):
    • In many states, parents are given a personal health record (known as the ‘Blue Book’ in some states and the ‘Red Book’ in others) when their child is born.
    • This includes a section to record immunisations.
  6. School Immunisation Records:
    • Some immunisations are administered at school, and the school or local public health unit may have a record of these.
  7. Workplace Vaccination Programs:
    • Some workplaces run vaccination programs (like annual flu shots or COVID-19 vaccination), and they may keep a record of these.

Immunocompromise – Prednisolone

Generally, the immunosuppressive effects of corticosteroids are dose-dependent, with higher doses and longer durations of treatment posing a greater risk.

The specific dose at which a patient is considered immunocompromised can vary, but some general guidelines are as follows:

  1. High Dose: Patients receiving prednisolone at a dose of 20 mg per day (or the equivalent) for more than two weeks are often considered at significant risk of being immunosuppressed.
  2. Moderate Dose: Some guidelines consider doses as low as 10 mg per day of prednisolone (or equivalent) for extended periods (usually more than a month) as potentially immunosuppressive.
  3. It is worth noting that ~ 7.5 mg of prednisolone a day is equivalent to normal physiological cortisone production.

Immunocompromise – Live Vaccines

Live attenuated vaccines (LAV) should be used with caution people who are immunocompromised. The live vaccines are:

  1. Measles, Mumps, Rubella (MMR): This vaccine protects against these three viral diseases. (Priorix and MMR-II)
  2. Rotavirus: This oral vaccine is used to protect infants from rotavirus, a leading cause of severe diarrhea in babies and young children. (Rotarix)
  3. Varicella (Chickenpox): This vaccine is designed to prevent chickenpox. (Priorix Tetra – with MMR).
  4. Zostervax (Shingles): This vaccine prevents shingles in adults. Zostavax is a live version, but it has been largely replaced by the non-live Shingrix.
  5. Tuberculosis (BCG): Used in countries where tuberculosis is common, this vaccine is not generally used in the United States or Australia.
  6. Oral Polio Vaccine (OPV): This is used in some countries to protect against polio. However, in many countries including the Australia, the inactivated polio vaccine (IPV) is used instead because of safety reasons.
  7. Yellow Fever: This vaccine is typically given to travelers visiting areas where yellow fever is endemic. The common brand is YF-Vax.
  8. Japanese Encephalitis (Imojev but not JEspect)
  9. Typhoid: An oral vaccine used for travelers to certain countries where typhoid is common.
  10. Smallpox (Vaccinia): This vaccine is no longer given routinely since smallpox has been eradicated. It is, however, used for certain military personnel and laboratory workers who might be exposed to the virus.

Live vaccines contain a version of the living virus or bacteria that has been weakened (also known as attenuated) in the lab. Because they are close to the natural infection, they are good at teaching the immune system how to fight off the disease. However, because they contain living organisms, they can potentially cause disease in people with weak immune systems.

Risks associated with live vaccines in immunocompromised individuals include:

  1. Disease due to Vaccine Strain:
    • The weakened form of the virus or bacteria in the vaccine can potentially cause the disease it is meant to prevent in immunocompromised individuals.
    • For example, the live-attenuated varicella vaccine could potentially cause chickenpox in a person with a severely weakened immune system.
  2. Severe or Prolonged Vaccine Side Effects:
    • Immunocompromised people may have more serious side effects from the vaccine, or their side effects may last longer than usual.
  3. Poor Immune Response:
    • Immunocompromised individuals may not generate an adequate immune response to the vaccine, making it less effective at protecting them from the disease.
  4. Reactivation of Vaccine Virus:
    • In some cases, the vaccine strain could become latent in the body and reactivate later, causing disease.
    • This is a particular concern with live viral vaccines, such as the measles, mumps, and rubella (MMR) vaccine or the varicella vaccine for chickenpox.

Because of these risks, live vaccines are generally contraindicated in people who are immunocompromised. These include individuals:

  1. Severe Immunodeficiency:
    1. HIV/AIDS with severe immunosuppression (e.g., CD4 count below a certain threshold).
    2. Severe Combined Immunodeficiency (SCID).
    3. Chronic treatment with high-dose systemic corticosteroids: Typically, this refers to treatment with > 20mg daily over a period of 2 weeks or longer.
    4. Cancer treatments: Such as chemotherapy or radiation therapy that suppresses the immune system.
    5. Use of other immunosuppressive or immunomodulatory therapies: This includes drugs like biologic agents used for autoimmune diseases.
  2. Pregnancy:
    1. Live vaccines are generally contraindicated in pregnancy due to the theoretical risk to the fetus. This includes vaccines like MMR (measles, mumps, rubella) and Varicella (chickenpox)
  3. Bone Marrow or Organ Transplantation:
    1. Patients who have received a bone marrow or organ transplant and are on immunosuppressive therapy.
  4. Specific Chronic Diseases:
    1. Certain chronic conditions may preclude the use of live vaccines, depending on their severity and treatment.
    2. This includes diseases like systemic lupus erythematosus (SLE) or rheumatoid arthritis being treated with immunosuppressive drugs.

The decision to vaccinate an immunocompromised individual must be made on a case-by-case basis, considering the specific immune compromising condition, the degree of immunosuppression, the specific vaccine, and the risk of disease.

Anaphylaxis

Anaphylaxis is a Type I hypersensitivity reaction.

Treatment is:

  1. Call ambulance DRS ABCDE – Send For Help
  2. Lie the patient flat (if tolerated) or sitting if not.
  3. Do not stand the patient up
  4. High-flow oxygen (if available)
  5. Weight-based 1:1000 (1mg/ml) adrenaline IM up to 0.5mg.
    1. 10kg 0.1 mg (0.1ml of 1:1000)
    2. 20kg 0.2 mg (0.2ml of 1:1000)
    3. 30kg 0.3 mg (0.3ml of 1:1000)
    4. 40kg 0.4mg (0.4ml of 1:1000)
    5. 50+kg 0.5 mg (0.5ml of 1:1000)
  6. Adrenaline can be repeated every 5 minutes (if required)

It is vital that Oxygen and Adrenaline are available where vaccinations are given.

Antihistamines

  • Australian Resuscitation Council (ARC) guidelines for anaphylaxis management recommend the use of adrenaline as the only first-line treatment for anaphylaxis.
  • While commonly used in the management of allergic reactions, antihistamines are NOT the first-line treatment for anaphylaxis.
  • They may be used as adjunctive therapy in anaphylaxis management, but they are secondary to the immediate administration of adrenaline.
  • Antihistamines can help relieve some symptoms of an allergic reaction, such as itching or hives, but they do not counteract the severe, potentially life-threatening symptoms of anaphylaxis like airway swelling, severe breathing difficulties, or shock.