1. Acute onset of an illness (minutes to several hours) with simultaneous involvement of the skin, mucosal tissue, or both (eg, generalized hives, pruritus or flushing, swollen lips-tongue-uvula), and ≥1 of the following:

– Respiratory compromise (eg, dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)

– Reduced BP or associated symptoms of end-organ dysfunction (eg, hypotonia [collapse], syncope, incontinence)

– Severe GI symptoms (eg, severe crampy abdominal pain, repetitive vomiting), especially after exposure to nonfood allergens

2. Acute onset of hypotensiona or bronchospasm or laryngeal involvement after exposure to a known or highly probable allergen for that patient (minutes to several hours), even in the absence of typical skin involvement

a Hypotension in adults is defined as a decrease in systolic BP >30% from baseline or <90 mm Hg.