Anaphylaxis

Question 1

What is anaphylaxis?

Answer 1

AvB^Cv with skin and mucosal changes.

Serious allergic reaction, rapid in onset and life threatening.

Hypersensitivity reaction.

Question 2

Causes of anaphylaxis

Answer 2

Triggered by second or subsequent exposure to an irritant
Food, medication & insect bites
Deaths from food most prevalent in children and medication in adults

Question 3

Signs and symptoms of anaphylaxis

Answer 3

A - angioedema (swelling in lower level of skin), stridor 
B - dyspnoea, wheeze
C - signs of shock
D - collapse, impending doom
E - urticaria, flushing, itching

Question 4

Management of anaphylaxis

Answer 4

1. Remove trigger
2. Give adrenaline (1/1000 - 500mcg - every 5 mins)
3. O2
4. Don’t sit or stand up hypotensive patient
5. Give fluid

Question 5

Additional management considerations in anaphylaxis

Answer 5

Brush teeth in early stages. Do not delay administration of adrenaline.

Steroids in hospital.

Consider biphasic attack (less likely in less severe cases where pt responded to first adrenaline)

Question 6

Mediators in anaphylaxis (meaning against protection)

Answer 6

Histamine - vasodilation, increased vascular permeability, ^HR

Prostaglandin - bronchoconstriction, pulmonary & coronary vasoconstriction, peripheral vascular dilation

Leukotrienes - bronchoconstriction, ^vascular permeability