Allergy & Anaphylaxis Flashcards
The study of the body’s immune system
Immunology
Protects the human body from foreign substances and organisms
Immune system
Exaggerated immune response to any substance
Allergic reaction
Common chemicals released by body to combat a stimulus
Histamines and leukotrienes
The first time someone is exposed to an allergen they are ___
Sensitized
An extreme allergic reaction that is life threatening and involves multiple organ systems
Anaphylaxis
Two most common signs of anaphylaxis
- Urticaria
- Angioedema
Small areas of generalized itching or burning that appear as multiple small, raised areas on the skin
Urticaria (hives)
Areas of localized swelling
Angioedema
High-pitched whistling breath sound that is typically heard on expiration
Wheezing
Wheezing from anaphylaxis is usually caused by ___
Bronchospasm/bronchoconstriction and increased mucus production
Signs of possible upper airway narrowing
Voice changes and stridor
High-pitched respiratory sound that is usually hear on inspiration
Stridor
During anaphylaxis, you may note hypotension due to ___
Vasodilation
During anaphylaxis, you may note increased ___, causing fluid from the bloodstream to seep into the tissues
Capillary permeability
One symptom that is often overlooked in anaphylaxis patients
Gastrointestinal dysfunction
Five general categories of allergens
- Food
- Medication
- Plants
- Chemicals
- Insect bites and stings
Food allergy symptoms may take more than ___ to appear
30 minutes
Food allergy symptoms may not include ___
Skin signs
Common symptom of food allergy
Abdominal cramping, vomiting, & diarrhea
Most common source of anaphylaxis
Food allergy
Second most common source of anaphylaxis
Medication
Most common medication types to cause anaphylaxis
Antibiotics and NSAIDs
If medication is ___, the reaction may be immediate
Injected
An immediate reaction is within ___
30 minutes
Common plant allergens
Ragweed, ryegrass, maple, and oak
Common chemical allergen that affects health care
Latex
The act of injecting venom
Envenomation
If a bee stinger is not removed it can continue to inject venom fro up to ___
20 minutes
A harmful substance produced by living cells or organisms
Toxin
Signs and symptoms of insect stings and bites
- Sudden pain
- Swelling
- Localized heat
- Widespread urticaria
- Redness in light-skinned people
May be: - Itching
- Wheal
A raised, swollen, well-defined area on the skin
Wheal
Signs and symptoms of insect stings and bites in anaphylactic patients
- Stridor
- Bronchospasm
- Wheezing
- Chest tightness
- Coughing
- Dyspnea
- Anxiety
- GI complaints
- Hypotension
- Respiratory failure
- Confusion
Allergic reactions may present as ___ distress or as ___ distress in the form of shock
- Respiratory
- Cardiovascular
If your general impression finds the person anxious and in distress, ___
Immediately call for ALS backup
Most severe form of allergic reaction
Anaphylaxis
Anaphylaxis can cause rapid swelling of the ___
Upper airway
Can provide clues as to an allergy in a patient who cannot tell you
Medical identification tag
Signs of impending airway obstruction
- Swollen lips or tongue
- Hoarseness
- Stridor
Dyspnea may present with ___
- Increased work of breathing
- Use of accessory muscles
- Head bobbing
- Tripod positioning
- Nostril flaring
- Abnormal breath sounds
Wheezing occurs because of ___
Narrowing of the lower air passages
Narrowing of the lower air passages is mainly the result of ___
Contraction of muscles around the bronchioles in reaction to the allergen, and mobilization of mucus in an attempt to push out the allergen
Stridor occurs when ___
Swelling in the upper airway begins to close off the airway
Generally the best position for a patient with breathing distress from an allergic reaction
Fowler position
If a patient develops signs of shock, they should be placed in the ___ position
Supine
Positive pressure ventilations will force air beyond ___
The selling in the airway and into the lungs while you wait for more definitive treatment
Not all patients with anaphylaxis will present with respiratory distress, some will present with ___ such as ___
- Circulatory distress
- Hyptension
How to determine if patient is in circulatory distress quickly
Palpating for the presence and quality of a radial pulse
If anaphylaxis is suspected, or if a relatively mild allergic reaction appears to be worsening, ___
Immediate transport is warranted after epinephrine is given
Before leaving the scene of anaphylaxis, be sure to take along the patient’s ___
Medications
History taking questions specific to an allergic reaction
- Have any interventions already been completed?
- Has the patient experienced a severe allergic reaction in the past?
- Be alert for any statements regarding the ingestion of foods that commonly cause allergic reactions
Respiratory signs and symptoms of an allergic reaction
- Sneezing or an itchy, runny nose (early sign)
- Dyspnea
- Tightness in the chest or throat
- Irritating, persistent dry cough
- Hoarseness
- Rapid, labored, or noisy respirations
- Wheezing and/or stridor (may progress to a silent chest as a late sign)
Cardiovascular signs and symptoms of an allergic reaction
- Tachycardia (early sign)
- Red, flushed, hot skin (early sign) or pale, cyanotic, cook skin (late sign) as the vascular system fails
- Hypotension (late sign) as the blood vessels dilate
Skin signs and symptoms of an allergic reaction
- Flushing, itching, or burning skin, common over the face and chest
- Urticaria over large areas of the body (internal or external)
- Swelling, especially of the face, neck, hands, feet, and/or tongue, either local (angioedema) or generalized
- Cyanosis or pallor around the lips
- Warm, tingling feeling in the face, mouth, chest, feet, and hands
Other signs and symptoms of an allergic reaction
- Decreasing mental status (early sign of hypoperfusion), from mild confusion or lethargy to loss of consciousness or coma
- Anxiety, sense of impending doom
- Gastrointestinal problems, including nausea, vomiting, or abdominal cramps
- Headache
- Itchy, watery eyes
- Dizziness
If a patient with an allergic reaction is unconscious for the secondary assessment, remove clothing as necessary and observe for ___
Presence of bee stingers, signs of contact with chemicals, and other clues suggestive of a reaction. Look for a medical alert tag
How to remove an insect stinger
Scrape the skin with the edge of a sharp, stiff object like a credit card
After removing an insect stinger ___
Gently wash the area with soap and water or mild antiseptic
Position the patient with the insect stinger injection site positioned ___
Slightly below the level of the heart, and apply ice or cold packs to the area
Epinephrine is a ___
Sympathomimetic hormone
Sympathomimetic hormone
Mimics the sympathetic response
Epinephrine causes blood vessels to ___
Constrict
Epinephrine comes in two common forms
EpiPen
Auvi-Q
Auvi-Q comes in a third dose of ___ for those patients weighing ___
0.1 mg
17 to 33 lbs
The adult EpiPen delivers ___ of epinephrine
0.3 mg
The EpiPen Jr for infants/children delivers ___ of epinephrine
0.15 mg
How long to hold the EpiPen in place
3 seconds
After injecting the EpiPen, rub the area for ___
10 seconds
If the patient’s condition does not improve after ___, consider using another EpiPen
5 minutes
Indications for epinephrine
Severe allergic reaction causing airway, breathing, or circulatory compromise or an anaphylactic reaction
Contraindications for epinephrine
None in a life-threatening emergency; however consult medical control when the patient has a history of heart disease or acute coronary syndrome
Actions of epinephrine
Vasoconstriction and increased cardiac contractility, bronchodilation
Side effects of epinephrine
Tachycardia, sweating, pale skin, dizziness, headache, palpitations
An adult EpiPen can be used for a patient weighing over ___
66 lbs
Patients weighing less than ___ will have to be dosed individually for epinephrine
33 lbs
Epinephrine concentration for IM injection
1 mg/mL
