About Anaesthesia


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Adverse Drug reactions, Allergy and Anaphylaxis


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Investigation of Perioperative anaphylaxis


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Queensland Anaesthetic Reaction Clinic (QARC) provides expert and evidence-based investigation of adverse drug reactions associated with anaesthesia and the peri-operative period, including individualised planning for return to surgery after major anaphylaxis where surgery was abandoned.

Queensland Anaesthetic Reaction Clinic is the practice of Dr Christian Van Nieuwenhuysen – Anaesthetist; one of only a small number of anaesthetists in Australia with particular interest and expertise in the area of peri-operative drug allergy.

Investigation of Peri-operative Anaphylaxis

The first priority in anaesthetic anaphylaxis is your immediate management, stabilisation of the reaction and recovery period. Once this has occurred, detailed investigation of the episode needs to begin.

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A referral to QARC can be made by any doctor. If you have been given a referral, please contact QARC to make an appointment. If QARC has received a referral from an anaesthetist or surgeon we may contact you directly. If in any doubt, please call QARC to discuss the referral process.

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Read More Referral process

The timing of some types of allergy testing is important to get the most accurate results. For skin testing, it is best to be seen at 4 to 6 weeks after your reaction.

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This information is important for QARC to be able to provide you with the best care. In particular, skin testing results can be affected by some medications and medical conditions. If you have an appointment to see Dr Van Nieuwenhuysen at QARC, please complete it thoroughly.

Patient Registration

Before your appointment QARC will gather the relevant medical records relating to your reaction, and sometimes records from prior surgeries. In some situations, you may need to sign a release form authorising us to obtain records on your behalf.

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An initial 30-minute consultation is the usual first step, to assess your background and determine whether you need complex skin testing. In certain cases, an initial consultation may not be necessary, and you may be able to be booked immediately for skin testing

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Before your consultation
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Skin testing is the technique for identifying which substance caused your reaction. It is the most important element of investigation of peri-operative anaphylaxis. It is recommended in all cases where anaphylaxis is suspected. Surgery should not take place until suspected reactions have been thoroughly investigated.

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Before your appointment
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In addition to skin testing, blood tests may also be required, either before or after skin testing has taken place.

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Most often, results can be reported to you at the time of testing, and results are then sent by mail or email to your referring doctor. Results are usually clear, although rarely the results may be complex to interpret, or further testing may be needed

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The advice that Dr Van Nieuwenhuysen formulates after your testing is used by anaesthetists and surgeons to ensure that you do not suffer a repeat reaction again. This is the most critical step in the investigative process

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You have a role to play in prevention of future reactions.We will give advice on what information you need to keep, or have available next time you need surgery. We may advise you to obtain a medical alert bracelet for an allergy, or we may need to prescribe you an adrenaline auto-injector and educate you in its use.

More about Prevention of future reactions

If your surgery was abandoned due to anaphylaxis, then you may need to re-book surgery. The team at QARC will collaborate with the anaesthetist and surgeon to make sure that our advice is followed carefully and that you are kept as safe as possible

More about Return to surgery