{
  "abstract": "Aims and Objectives Avoidable deaths from airway obstruction due to isolated angioedema have been reported through NHS England’s Learning from Patient Safety Events system. These cases appear to have been caused by bradykinin-mediated angioedema, which does not respond to standard anaphylaxis treatment and for which no consensus previously existed regarding Emergency Department management. In response, the Royal College of Emergency Medicine (RCEM), in collaboration with multidisciplinary experts, has developed a consensus guideline outlining a treatment pathway for the assessment and management of isolated angioedema without allergic features in Emergency Departments (EDs).Method and Design A working group was convened with representatives from RCEM, British Pharmacological Society, British and Irish Hypertension Society, British Society for Immunology, British Society for Allergy and Clinical Immunology, UK Clinical Pharmacy Association, Difficult Airway Society, NHS England, and NHS Improvement (Patient Safety). An expert consensus approach was adopted to review current evidence and clinical practice. Through iterative discussion and peer review, a management algorithm for isolated angioedema was developed, supported by internal review and endorsement from participant professional bodies.Abstract 3939 Figure 1Results and Conclusion The final consensus guideline is expected to be published in 2026. High-quality data are lacking, but the group agreed that in the context of potentially preventable patient deaths, there is sufficient evidence to offer pragmatic clinical guidance while highlighting the need for further research. The agreed treatment pathway emphasises early airway assessment and intubation if necessary, with tranexamic acid recommended as first-line therapy and icatibant as second-line treatment. Criteria for monitoring, discharge and admission were also defined to promote consistent, evidence-informed decision-making.The key priorities of this guideline are clinician education, timely recognition of patients at risk of airway compromise, and the exclusion of anaphylaxis. Adherence to the algorithm aims to standardise ED management, enhance patient safety, and reduce avoidable morbidity and mortality associated with isolated angioedema. Further clinical trials are urgently needed.",
  "authors": [
    {
      "affiliations": [
        "Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, UK"
      ],
      "name": "Karen Erskine"
    },
    {
      "affiliations": [
        "Institute for Neuroscience and Cardiovascular Research, Queen’s Medical Research Institute, Edinburgh, UK"
      ],
      "name": "Christopher Humphries"
    }
  ],
  "title": "3939 Development of an RCEM consensus guideline for the assessment and management of isolated angioedema",
  "uid": "ec5826c0-1ea2-5577-a7f4-094b072b599e"
}