Table 2.

Grading the severity of anaphylaxis

Grade	Skin	GI tract	Respiratory	Cardiovascular	Neurological
1 Mild	Sudden itching of eyes and nose, generalized pruritus, flushing, urticaria, angioedema	Oral pruritus, oral “tingling”, mild lip swelling, nausea or emesis, mild abdominal pain	Nasal congestion and/or sneezing, rhinorrhea, throat pruritus, throat tightness, mild wheezing	Tachycardia (increase >15 b.p.m.)	Change in activity level plus anxiety
2 Moderate	Any of the above	Any of the above, crampy abdominal pain, diarrhea, recurrent vomiting	Any of the above, hoarseness, “barky” cough, difficulty swallowing, stridor, dyspnea, moderate wheezing	As above	Light headedness, feeling of “impending doom”
3 Severe	Any of the above	Any of the above, loss of bowel control	Any of the above, cyanosis or saturation <92%, respiratory arrest	Hypotension † and/or collapse, dysrhythmia, severe bradycardia and/or cardiac arrest	Confusion, loss of consciousness

The severity score should be based on the organ system most affected.

^†Hypotension defined as systolic blood pressure <90 mmHg (adult).