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A safer path to surgery for allergy-prone patients
The Perioperative Anaphylaxis Clinic (POAC) at Vancouver General Hospital is Canada's first clinic to unite anesthesiology, allergy, and immunology experts to care for patients who have experienced severe allergic reactions during surgery. This unique collaboration creates a patient-centered approach tailored to the individual needs of each patient.
Pictured above: Dr. Ruiz (left) and Dr. Foglia (right). Photo credit: Dr. Cyrus McEachern
During surgery, patients may be exposed to medications and agents they do not encounter in daily life. In rare instances, they can trigger life-threatening anaphylaxis and interrupt a surgery before it is complete. Without a clear cause, surgery can be delayed, bringing stress to the patient and the surgical team.
Dr. Julena Foglia, co-director of the PAOC, says anaphylaxis reactions during surgery happen while patients are unconscious, so identifying the cause can be difficult.
“There are a lot of things that could present similarly. It is not necessarily easy to confirm this is an allergy," says Dr. Foglia.
The clinic has a team with dedicated expertise, access to complete surgical records and specific medications, including restricted substances and anesthesia. Working together, experts can accurately identify allergens in each specific surgical environment.
Traditionally, patients were referred to outpatient allergists after surgery, but it was still challenging to get a clear diagnosis.
“There is very limited information for an outpatient allergist. Outside the hospital, they may not have access to test the specific medications used in the operating room. In addition, the patient was under anesthesia during the reaction and is unable to provide a first-hand account of what happened." says Dr. Juan Ruiz, co-director of the PAOC.
At the clinic, patients can expect detailed investigations and longer consultations to fully uncover their unique histories. In-depth testing can be done directly in a hospital environment as a precaution against a severe reaction.
By bringing together expertise, resources and communication, this specialized team is transforming care—making surgery safer, less stressful, and more accessible.
