HISTORY. Obtain information about any recent food intake, medication ingestion, outdoor activities and exposure to insects, or known allergies. Symptoms usually begin within 5 to 30 minutes, and the earlier the signs and symptoms begin, the more severe the reaction. Often the signs and symptoms begin with skin and respiratory involvement and include (Box 3):

• BOX 3 Signs and Symptoms of Anaphylaxis


Urticaria (rash), angioedema, sneezing, conjunctival pruritus, swelling,

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