Anaphylaxis Flashcards
What are the 3 criteria for anaphylaxis?
Sudden onset and rapid progression of symptoms
Life threatening AB or C problems
Skin or mucosal changes
What are some symptoms of anaphylaxis?
Feeling hot, tingling in lips, anxiety urticaria wheezing, SOB LOC, dizziness, headache, blurred vision metallic taste
What are some differential diagnosis for anaphylactic shock?
panic attack septic shock infection asthma attack mild allergic reaction aspiration
What are the symptoms of anaphlaxis by ABCDE?
A - airway swelling, hoarse voice, stridor
B - SOB, wheeze, confusion, tired, cyanosis, respiratory arrest
C - pale, clammy, tachycardia, hypotension, LOC, ECG changes, cardiac arrest
D - itchy, pain, N&V
E - skin changes
What is some pathophysiology of anaphylaxis?
Allergen binds to IgE which causes mast cells to release histamine, which attaches to H1 receptors causing vasodilation and increased vascular permeability
What is an anaphylactoid reaction?
not IgE mediated, but causes similar mast cell activation
What is the drug order for anaphylactic shock?
Adrenaline - every 5 mins IV fluid challenge Chlorphenamine Neb salbutamol or adrenaline Hydrocortisone (for 3 days afterwards)
What is the adult dose and route of adrenaline?
IM 500 micrograms
What blood test is dignostic of anaphylaxis?
mast cell tryptase
3 tests ideally - 1-2 hours after symptoms, as soon as possible after resus, 24 hours after symptoms settle down
How long should people be observed after anaphylactic shock?
4-6 hours for adults
6-10 hours for children
What is a biphasic reaction?
another reaction without second exposure to allergen
1-20% reactions
6-10 (2-72) hours
What increases risk of biphasic reaction?
more than one adrenaline shot, salbutamol to control resp symptoms, delaying adrenaline 90 mins, wide pulse pressure, hypotension
What should you do for follow up after an anaphylaxis reaction?
GP
allergy clinic
2 adrenaline auto-injector
