Anaphylaxis CPG Flashcards
(24 cards)
what is the definition of anaphylaxis?
severe, potentially life threatening systemic hypersensitivity reaction
what is the typical onset of anaphylaxis?
usually 30 minutes but may be up to 4 hours
when is anaphylaxis accepted?
if there are two systemic manifestations observed irrespective of if there is a know allergen
why des respect distress occur in anaphylaxis?
due to inflammatory bronchconstirction or upper airway oedema
what abdominal signs may be observed with anaphylaxis?
pain/cramping, nausea, vomiting, diarrhoea- particularly with insect bites and systemically administered allergens ie IV medications
what skin symptoms may be seen with anaphylaxis?
hives, welts, itching, flushing, angioedema (lips and tongue)- due to vasdilation and vascular hyperpermiability
what cardiovascular symptoms may be observed with anaphylaxis?
hypotension due to vascular hyperpermiability
what are some common allergens that may cause anaphylaxis?
insect sings - bees wasps, ants, food- peanuts, egg, m fish medications exerrcise induce idiopathic anaphylaxis- no trigger
when should the paitents own medication be used instead of anaphylaxis managment?
where HAE or bradykinin-medicated angiodema is identified and the patient has their own medication plan
when should escalation of care be considered?
elected clinical course- ICU admission, multiple adrenaline administration
hypotension <90
medication as Ppercipertating cause
resp symptoms
history of asthma or multiple other co-morbidities/medications
or no response to initial dose of IM adrenaline
what is the administration site for adrenaline in the setting of anaphylaxis?
anterolateral mid-thigh
when might it be suggeestive that the patient is suffering from adrenaline toxicity rather than worsening anaphylaxis?
when the patient develops nausea, vomiting, shaking, tachycardia or arythmias but has some improvement in symptoms and a raised BP
when can additional therapies be administered?
concurrently in order of clinical relevance however should not delay the administration of adrenaline
what does inotropic mean?
medication that changes the force/speed of muscle contraction
what does a chronotropic drug do?
effects electrical conduction pathways in the heart alerting
what patients do we consider giving IM glucagon to and why?
paitents with a history of heart failure or paitents taking beta blockers
because it has an introit, chronotropic and antibronchospastic effect
what should we do with mangamgnet plans?
consider action plan and align care in accordance to recommendations
how long do paitents need to be observed in the hospital for after a reaction?
for a minim of 4 hours in case of a biphasic reaction
what is the anaphylaxis criteria to treat as anaphylaxis?
sudden onset under 30 mins up to 4 hours
rash two or more respirtory distress abdominal symptoms skin/muscosal symptoms hypotension
or isloated hypotension <90 with know allaergen
or isolated resp distress following know allaergen
what is the first line treatment for anaphylaxis?
500mgc Im adrenalin repate at 5 mins as required
request mica if first does not responsive
insert IV and O2 15L non rebreather
what is the aditinal treatment is there is airway odeam/stridor?
adrenalin 5mg nebulised
- consult for further dose if required
- notify hopsital
what is the aditinal treatment if there is bronchospasm?
Nebulised 5mg salbutamol or 4-12 pMDI repate at 20 mins if required
Ipatropium bromide 500mcg nebulised or pMDI 8 doses
Dexamethasone 8mg IV/Oral
what are the additanl treatments if there is Hypotension?
<90 despite intial dose adrenaline
normal saline 40ml/kg tritrated to respnse- consult for further if required
consult not avaliable additional 20ml/kg
what are the additaonal treatements for inadeqaute response to adrenaline with ahistory of heart ailure or taking beta-blockers
Glucagon 1mg Im repate once @ 5mins if required
