anaphylaxis

Question 1

resus council defiiniton of anaphylaxs

Answer 1

sudden onsset and rapid progression of symptoms airway /- breathing +/- circulation problems

A = swelling of throat+tongue -> hoarse voice + stridor

B = respiratory wheeze, dyspnoea

C = hypotension, tachycardia

Question 2

adrenaline dose for 6months old

Answer 2

100-150micrograms

(0.1-0.15ml 1 in 1000)

Question 3

adrenaline dose for 6months-6years

Answer 3

150micrograms

(0.15ml 1 iin 1000)

Question 4

adrenaline dose for 6-12yrs

Answer 4

300 micrograms

0.3ml 1 iin 1000

Question 5

adrenaline dose for >12yrs / adult

Answer 5

500 miicrograms

0.5ml 1 in 1000

Question 6

how often can adrenaline be repeated in the management of anaphylaxis

Answer 6

every 5 mins

Question 7

best site for IM injection of adrenaline

Answer 7

anterolateral aspect of middle third of thigh

Question 8

refractory anaphylaxis definition

Answer 8

resp +/- cardio problems that persist despite 2 doses of IM adrenaline

Question 9

refractory anaphylaxis management

Answer 9

• IV fluids for shoc
• consider IV adrenaline infusion

Question 10

if you’re not sure iif it was a true anaphylaxis, which test can be done?

Answer 10

serum tryptase
- they remain elevated up to 12hrs following anaphylaxis

Question 11

management following stabilisation of anaphylaxis

Answer 11

• non-sedating antihistamines = chlorphenamine
• new diagnosis -> specialist allergy clinic
• careful when discharging -> biphasic reactions occur in 20%

Question 12

different timings of discharge based on anaphylaxis

Answer 12

fasttrac (after 2hrs of sx resolution)
- good response to single dose + complete resolution of sx

min 6hrs post-sx resolution
- 2 doses of IM adren needed
- previous biphasic

min 12hrs (everything else)
- >2doses
- severe asthma
- px late at night
- poss ongoing reaction
- area where access in emergency difficult