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Flashcards in Management Acute Deck (16)
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1
Q

What is anaphylaxis

A

Life threatening severe type 1 allergic reaction

- IgE responds inappropriately to allergen causing release of histamine and other substances

2
Q

How does it present

80% present rash + angiooedema but 20% don’t

A
Sudden onset rapid progression of Sx
Skin / mucosal change 
- Erythema - patchy or generalised red rash 
- Urticaria (Hives) 
- Flushing 
- Itch 
- Angio-oedema - similar to urticaria but swelling of deeper tissue e.g. eyes / mouth but sometimes airway 
Upper airway oedema and bronchospasm - common in asthmatics 
Abdo pain
N+V
Indicative of anaphylaxis = airway / breathing compromise
- Stridor
- Wheeze
- Tachycardia
- SOB
- Collapse
- Hypotension
3
Q

How do you treat

A

ABCDE
- O2, IV access, fluid bolus etc
- 500ml adult saline
- 20 ml / kg child saline
Call 2222 - consider anaesthetist if think airway compromised
Remove trigger
If breathing normal = lie flat and raise head
If breathing compromised = sit up and monitor
Adrenaline IM anterolateral aspect of mid thigh
Repeat every 5 minutes even if detioerrate
Hydrocortisone IV
Chloroamphetamine IV
Can give salbutamol if wheezing

4
Q

Doses adrenaline

A

1 in 1000
>12 = 0.5ml
6-12 = 0.3ml
<6 = 0.15ml

5
Q

Doses hydrocortisone

A

200mg >12
100mg >6-12
50 mg >6 months-6
25mg <6 months

6
Q

Doses chloroamphetamine

A

10mg >12
5mg 6months-12
2.5mg <6months

7
Q

What may be needed

A

Intubation

8
Q

What can be taken after to prove anaphylaxis

A

Serum typrtase

9
Q

What must you do after an episode of anaphylaxis

A

Observe patient for 6-12 hours incase biphasic reaction occurs
Observe 24 hours if severe reaction, severe asthma, allergen trigger still present, previous Hx of biphasic reaction
Teach about epipen
Refer to allergic clinic

10
Q

What does of adrenaline in rests

A

1 in 10,000 10ml IV

11
Q

Cardiac arrest

A

OK

12
Q

Common drugs causing anaphylaxis

A

Anaesthetic
Muscle relaxant
Ax
NSAID / aspirin

13
Q

If bee sting has caused reaction what is important to do

A

Remove

14
Q

What are the Ddx to consider of anaphylaxis

A
Asthma 
- Use Adrenaline first as will treat both
- Use inhaler / nebuliser 
Septic shock
- Hypotension with purpuric rash
- Sepsis 6 
Other
- Vasovagal
- Panic attack
- Idiopathic urticaria
15
Q

If patient states struggling to breath and hoarse voice / closing up

A

IM adrenaline ASAP

16
Q

If hypotensive

A

Lie flat and raise legs