Anaphylaxis and allergy

Question 1

Risk of death

Answer 1

<ul> <li>1.Previous near fatal rxn in past</li> <li>2. Delay presentation and more importantly delayed administration of IM epi</li> <li>3. Asthma – Especially poorly controlled</li> <li>Exacerbators include: ETOH, NSAIDS, Exercise, Viral illness</li> </ul>

Question 2

Emergency Rx of Anaphylaxis

Answer 2

ABC<br></br>Epi 0.5 mg im repeat q 5 min prn (0.01 mg/kg in peds)<br></br>Anti H1 (Diphenhydramine) 1mg/kg max 50 mg iv<br></br>Anti H2 (Ranitidine) 1mg/kg max 50 iv or 300 po<br></br>Rx of bronchospasm like asthma<br></br>Steroids<br></br>In shock ==>epi drip with +++fluids<br></br>

Question 3

<p>Disposition</p>

Answer 3

<ul> <li>Usually observe for 6 hours. The sicker the longer</li> <li>Prednisone +/- again for sicker and idiopathic</li> <li>Train on how to use Epipen</li> <li>Ensure they have an epipen to go home with</li> <li>Refer for testing if new allergy</li> <li>Consider MediAlert bracelet</li> <li>Beware of patient on Bblocker. May have to give lower dose Epi and consider Glucagon</li> </ul>