Emerg

Question 1

Clinical features of anaphylaxis?

Answer 1

Any acute onset of:

1. Hypotension
2. Bronchospasm
3. Upper airway obstruction

WHERE ANAPHYLAXIS is considered possible - even if no skin symptoms.

OR

Any acute onset of typical skin features - erythema, urticaria and/or angioedema

PLUS

Respiratory, Cardiovascular or persistent GIT symptoms

Question 2

Acute management of Anaphylaxis? Post acute care?

Answer 2

1. Call for assistance
2. Stop exposure to causative agent if possible
3. Give IM adrenaline mid lateral thigh - (0.01mg/kg) (Max adult dose is 0.5mg)
4. Lay patient flat (elevate legs if tolerated).
5. Set up wide bore IV access
6. IF hypotensive give: Administer IV fluid bolus Normal Saline 0.9% fluid bolus 20ml/kg
7. If Oxygen Saturation below 93% - give oxygen 8 litres via hudson mask to maintain oxygen saturations above 94%
8. IF inadequate response - give another does of IM adrenaline in 5 minutes

POST ACUTE CARE:

Discharge with epi pen (may need extra one for work/school or to keep with parents)

Education regarding acute management, trigger avoidance

Anaphylaxis management plan

Refer to allergy specialist for consideration of desensitisation therapy