Anaphylaxis

Question 1

what is anaphylactic shock?

Answer 1

rapid onset TYPE 1 IgE-mediated hypersensitivity reaction that develops when a patient is exposed to certain percipitants

Question 2

name some causes of anaphylaxis?

Answer 2

• insect stings
• nuts
• other foods
• antibiotics
• IV contrast
• other medications

Question 3

describe the skin presentation in anaphylaxis

Answer 3

• widespread urticaria
• itching
• flushed skin

Question 4

describe the respiratory symptoms seen in anaphylaxis

Answer 4

• swollen tongue/lips
• sneezing
• wheeze

Question 5

describe the GI symptoms in anaphylaxis

Answer 5

• abdominal pain
• nausea
• vomiting
• diarrhoea

Question 6

describe the cardiac signs in anaphylaxis

Answer 6

• tachycardia
• hypotension

Question 7

what investigation can be done to confirm anaphylaxis?

Answer 7

• serum levels of mast cell tryptase
• samples should be taken during, 4hr and 12hr post-reaction

Question 8

what is the management of anaphylaxis?

Answer 8

1. remove trigger if possible
2. call for help early
3. ABCDE
4. administer oxygen
5. lie patient flat and raise legs
6. administer adrenaline (500mcg IM)
7. administer chlorphenamine and hydrocortisone
8. IV fluid challenge if hypotensive

Question 9

what is the adult dose of adrenaline given in anaphylaxis?

Answer 9

• 500 mcg IM
• middle third of anterolateral thigh
• can be repeated every 5 mins

Question 10

what is the paediatric dose (6-12 years) of adrenaline given in anaphylaxis?

Answer 10

300mcg IM

Question 11

what is the typical pathology of breathing heard in anaphylaxis?

Answer 11

stridor = inspiratory wheeze