Pourmand A, et al. - Considering the fear concerning the biphasic reaction in anaphylaxis management in the Emergency Department (ED), researchers sought for evidence-base for the traditional recommendation of ED observation time 4–6 h after complete resolution of symptoms for every anaphylaxis patient. Majority of the studies showed the mean time to onset between the resolution of initial anaphylaxis and biphasic reaction of >8 h. Biphasic reactions had low incidence and rare mortality. It seems that patients who receive epinephrine within one hour of symptom onset and who respond to epinephrine with rapid and complete symptom resolution can probably be discharged from the ED with careful return precautions and education without the need for prolonged observation.