Anaphylaxis

Question 1

What is the treatment for anaphylaxis in adults?

Answer 1

High flow O2

Adrenaline 500mcg IM

• repeat 5 mins
• no max

If FRAIL
Adrenaline 300mcg IM

Manasged brocnhopspasm with salbutamol as per Asthma

Manage inadequate perfusion
- NS max 40ml/kg
consult for additional 20ml/kg

Do not allow patient to stand or walk

Question 2

What do you look for in determining anaphylaxis

Answer 2

Two or more RASH Criteria with or without a confirmed antigen exposure

OR

Isolated hypotension (SBP <90) following exposure to known antigen

Question 3

What is the RASH criteria for anaphylaxis?

Answer 3

Respiratory distress
Abdominal symptoms
Skin/mucosal symptoms
Hypotension (or altered conscious state)

Question 4

What is the treatment for anaphylaxis in paeds?

Answer 4

Adrenaline 10mcg/kg
- repeat 10mck/kg @5 mins as required

Treat bronchospasm with salbutamol as per asthma

Nebulised adrenaline for UOA

Question 5

What are the precautions of adrenaline?

Answer 5

1. Elderly/frail
2. Pts with a cardiovascular disease
3. Pts on Monoamine oxidase inhibitors
4. Higher doses may be required for pts on beta blockers

Question 6

what are the side effects of adrenaline

Answer 6

• ST
• supraventiricular arrythm,ias
• Ventricular arrythmias
• Hypertension
• Pupillary dilation
• May increase sizeof MI
• anxiety/palpitations

Question 7

What is the onset peak and duration of IV adrenaline?

Answer 7

onset - 30 sec
peak - 3-5 mins
duration - 5-10 mins

Question 8

What is the onset peak and duration of IM adrenaline?

Answer 8

onset - 30-90 sec
peak - 4-10 mins
duration - 5-10 mins