26 - anaphylaxis

Question 1

general def. of ana

Answer 1

severe allergic reaction to any stim, usually with sudden onset and lasting less than 24 hours, producing one or more of: hives, flush, itch, angioedema, stridor, wheeze, SOB, vomiting, diarrhea, or shock

Question 2

most common allergens

Answer 2

1. foods
   - esp peanuts and tree nuts
2. iatrogenic
   - 56% in OR
   - Abx
3. stings
4. latex

Question 3

pathophys

Answer 3

1. IgE mediated
2. previous exposure required
3. causes mast cells to degranulate
4. histamine activates H1 and H2

Question 4

mgmt of ana

Answer 4

1. ABCs
   - possible airway
   - 100% O2
   - B2 agon for wheeze
   - crystalloid
2. epi 1:1000 0.3-0.5mg IM
   - if on BBs, may not respond - give glucagon IV
3. 50mg of benadryl and 50mg of ranatadine
4. steroids
   - methyprednisalone - helps for later

Question 5

dispo for ana

Answer 5

monitor for 4-6 hours in ER

• H1, H2, and steroid for 3 day course
• tell about injections

Question 6

what to tell on discharge

Answer 6

• epi-pen
• take benadryl
• medic alert bracelet