Anaphylaxis

Question 1

Common causes

Answer 1

Food (most common cause in children)

Drugs

Venom

Question 2

Airway problems

Answer 2

Swelling of the throat and tongue

Hoarse voice and stridor

Question 3

Breathing problems

Answer 3

Respiratory wheeze

Dyspnoea

Question 4

Circulation problems

Answer 4

Hypotension

Tachycardia

Question 5

Anaphylaxis definition

Answer 5

Sudden onset and rapid progression of symptoms

Airway and/or breathing and/or circulation problems

Without ABC problems its technically not anaphylaxis

Question 6

Skin/ mucosal changes

Answer 6

Generalised pruritis

Widespread erythematous or urticarial rash

Question 7

Management

Answer 7

IM adrenaline

Question 8

Adrenaline <6 month old

Answer 8

100-150micrograms

Question 9

Adrenaline 6months-6years

Answer 9

150micrograms

Question 10

Adrenaline 6-12years

Answer 10

300micrograms

Question 11

Adrenaline adult and child >12 years

Answer 11

500micrograms

Question 12

Refractory anaphylaxis

Answer 12

Respiratory and/or cardiovascular problems persist despite 2 doses of IM adrenaline

IV fluids should be given for shock

Question 13

Management following stabilisation

Answer 13

Non-sedating oral antihistamines particularly if persisting skin problems

Serum tryptase remain elevated up to 12 hours following acute episode

New diagnosis of anaphylaxis need referral to specialist allergy clinic

Question 14

Types of discharge

Answer 14

Fast-track

Minimum 6 hours after symptom resolution

Minimum 12 hours after symptom resolution

Question 15

Fast-track discharge

Answer 15

Good response to single dose of adrenaline

Complete resolution of symptoms

Given adrenaline auto-injector and trained how to use it

Adequate supervision following discharge

Question 16

Minimum 6 hours after symptom resolution

Answer 16

2 doses of IM adrenaline needed or previous biphasic reaction

Question 17

Minimum 12 hours after symptom resolution

Answer 17

Severe reaction requiring >2 doses of IM adrenaline

Patient has severe asthma

Possibility of ongoing reaction

Patient presents late at night

Patient in area where access to emergency access care may be difficult