A+E

Question 1

Components of LA?

Answer 1

Anaesthetic, vasoconstrictor, vehicle, reducing agent, fungicide, preservative

Question 2

What is anaphylaxis and what would you see?

Answer 2

Type I hypersensitivity

Swelling of tissue, facial flushing, cold and clammy skin, urticaria, wheezing, tachycardia, hypotension

Question 3

Management anaphylaxis?

Answer 3

Lay pt flat
Adminsister 0.5ml adrenaline IM - repeat after 5 mins if needed
Ensure clear airway - 100% oxygen

Question 4

Role of adrenaline?

Answer 4

Reverse peripheral vasodilation and reduce oedema
Dilation of airway
Suppress histamine and leyukotrine release

Question 5

How may anaphylaxis be tx hospital?

Answer 5

10-20mg chlorphenamine IV

100mg hydrocortisone - reduce oedema and stabilise mast cell

Question 6

Symptoms that might prompt to use adrenaline?

Answer 6

Angio-oedema - bronchospasm, larygngoedma, hypotension

Question 7

Hospital tx?

Answer 7

1. Observation
2. Oxygen w/ face mask to help breathing
3. Fluid - increase BP
4. Antihistamien and steroid to relive symptoms

Question 8

Use of immunologist?

Answer 8

IgE mediated attack occur previously sensitised people -

Referred to identify cause - reduce risk future reaction

Question 9

What medical conditions/ allergies may put pt at risk of latex allergy?

Answer 9

Risk: atopy, spinabifida, asthma, hay fever, eczema
Food: avocado, chestnut, banana, kiwi

Immunological cross-reactivity between proteins and enzyme in food and latex

Question 10

What is urticarial rash?

Answer 10

Raised, itchy red rash
Often caused high level of histamine -allergic reaction, infection, cold/ head exposure
First symptom of anaphylaxis

Question 11

Tx urticarial rash?

Answer 11

Often not needed
Antihistamine can help discomfort
Short course steroid - severe case
Referral allergy testing (if +6week unlikely to be allergy)