Participating

To start with a new questionnaire, please provide the following data:

Anaesthesiologist:

R.I.Z.I.V.-number - - - * (required field)

Hospital: 

E-mail address *(this will be used to send you a copy of the completed questionnaire)

Please note that the questionnaire has to be completed in one session. If you close it somewhere in the middle, you cannot resume later on.
It takes about 15 min to fill in the questionnaire.

A printable version of the questionnaire is also available (pdf)

About the survey

The questionnaire consists of the following parts:

1. Patient demography
2. Medical history
3. Surgical and anaesthetic history
4. Allergic history
5. The suspected anaphylactic reaction
   1. Drugs and substances used BEFORE the start of the suspected anaphylactic reaction
   2. Symptoms and signs of the suspected anaphylactic reaction
   3. Treatment of the suspected anaphylactic reaction
   4. Outcome of the suspected anaphylactic reaction
      
6. Primary investigation: mast cell tryptase
7. Secondary investigation: major allergy labs
8. Conclusion