Anaphylaxis

Question 1

What is anaphylaxis?

Answer 1

Type I IgE mediated hypersensitivity reaction

Question 2

What are the symptoms of anaphylaxis?

Answer 2

• Wheeze
• Cyanosis
• Tachycardia
• Hypotension
• Itching, sweating, diarrhoea, erythema, urticaria, oedema

Question 3

What conditions can mimic anaphylaxis?

Answer 3

• Carcinoid
• Pheochromocytoma
• Systemic mastocytosis
• Hereditary angioedema

Question 4

What are the steps in managing anaphylaxis?

Answer 4

1. Secure airway
2. Remove cause
3. Give adrenaline
4. Secure IV access
5. Chlorphenamine and hydrocortisone
6. IV fluids

Question 5

What may be involving in securing the airway in anaphylaxis?

Answer 5

Intubating if respiratory obstruction imminent

Question 6

What dose of adrenaline is given in anaphylaxis?

Answer 6

0.5mg IM (0.5ml of 1:1000)

Question 7

When can the dose of adrenaline be repeated?

Answer 7

Every 5 mins if needed until better

Question 8

What dose of chlorphenamine is given in anaphylaxis?

Answer 8

10mg IV

Question 9

What dose of hydrocortisone is given in anaphylaxis?

Answer 9

200mg IV

Question 10

What should be done if there is a wheeze in anaphylaxis?

Answer 10

Treat as for asthma

Question 11

What may be required if still hypotensive after treatment for anaphylaxis?

Answer 11

Admission to ICU and IV adrenaline, +- aminophylline and nebulised salbutamol

Question 12

What is involved in further management of patient with anaphylaxis?

Answer 12

• Admit to ward and monitor ECG
• Measure serum tryptase 1-6 hours after suspected anaphylaxis
• Continue chlorphenamine 4mg/6hour PO if itching