Allergic Reaction/ Anaphylaxis Protocol

Question 1

Define allergic reaction?

Answer 1

typically localized or generalized swelling

Question 2

Define anaphylaxis

Answer 2

Defined by wheezing, airway compromise, and/ systolic BP lower than 90mmHg

Question 3

What HPI do you need with allergic reaction/ anaphylaxis?

Answer 3

Onset, location, sting, bite, food allergy exposure, history of reactions, medication history

Question 4

Signs and symptoms of allergic reaction/ anaphylaxis

Answer 4

itching, hives, coughing, wheezing, respiratory distress, chest or throat constriction, difficulty swallowing, hypotension, shock, edema

Question 5

Differentials for anaphylaxis or allergic reaction

Answer 5

rash only, anaphylaxis, shock, angioedema, aspiration or airway obstruction, asthma, COPD, CHF

Question 6

Walk through protocol BLS to ALS for hives only:

Answer 6

DRABCDE, oxygen, cardiac monitor, IV est. to keep BP of at least 90, diphenhydramine

Question 7

What is the dosage and route for diphenhydramine in this protocol?

Answer 7

25-50mg IV or IM

Question 8

What is the protocol when there is severe respiratory involvement?

Answer 8

Capnography, epinephrine 0.3 mg IM 1:1000, diphenhydramine 50mg IV, if wheezing then administer neb. treatment of albuterol 5mg, 0.5 atrovent with 6-* liters of oxygen, administer dexamethasone IV/IM/PO 10 mg, administer repeat albuterol 5mg neb as needed until waveform comes back to normal.

Question 9

When can dexamethasone be administered?

Answer 9

only after transport is administered