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DME > Anaphalaxis > Flashcards

Anaphalaxis Flashcards

1
Q

what do you look for in anaphalaxis?

A
  • sudden onset
  • rapid progression
  • life threatening (airway, breathing, circulation)
  • skin or mucosal changes
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2
Q

what to do if patient has an anaphalaxis reaction?

A
  • Call 999
  • semi recline pt and elevate legs
  • remove trigger if possible
  • give intramuscular adrenaline
  • give 15L/min oxygen via non-rebreather mask (use pulse oximeter and BP monitoring)
  • give salbutamol to treat wheeze or stridor (2 activations every 2 minutes, max 10)
  • reassess pt
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3
Q

what does of adrenaline do you give for a child less than 6 months

A

0.1-0.15 ml (100-150 micrograms)

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4
Q

what dose of adrenaline given to pt less than 6 years

A

0.15ml (150 micrograms)

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5
Q

what dose of adrenaline do we give to a pt aged 6-12yrs

A

0.3ml (300 micrograms)

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6
Q

what dose of adrenaline do we give a pt aged more than 12 yrs

A

0.5ml (500 micrograms)

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7
Q

what do we do if pt starts to get better in reassessment

A

monitor ABCDE
- complete incident report

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8
Q

what do we do if the pt remains the same of gets worse

A

reassess and retreat as per algorithm and confirm ambulance is called
- complete incident report

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9
Q

what are the reported symptoms for Airway

A

itching
difficulty swallowing

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10
Q

what are the clinical findings of Airway

A

stridor / wheeze/ hoarse voice
swelling (tongue or soft palate

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11
Q

what are the reported symptoms of Breathing

A

cough
shortness of breath
runny nose

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12
Q

what are the clinical findings for breathing

A

high respiratory rate
oxygen saturations below 94%

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13
Q

what are the reported symptoms of circulation

A

dizziness
visual disturbances
pallor

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14
Q

what are the clinical findings for circulation

A

high heart rate
low blood pressure
high capillary refill time

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15
Q

what are the symptoms for disability

A

agitation/fear
anxiety

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16
Q

what are the clinical finding for disability

A

reduced conciousness
fatigue
confusion

17
Q

what are the symptoms for exposure

A

itching
sweaty
cold peripheries

18
Q

what are the clinical findings for exposure

A

rash
flushed appearance
cyanosis
angiodema

19
Q

what are the additonal symptoms of anaphalaxis reaction

A

nausea
vomiting
abdominal pain

20
Q

are all skin or mucosal changes anaphalaxis reaction

A

no, only 20% anaphalaxis reaction have skin/mucosal changes

21
Q

True of False: Administration of adrenaline may be repeated at 2 minute intervals.

A

FALSE
Administration of adrenaline may be repeated at 5 minute intervals.

22
Q

True or False: If no improvement after TWO doses of adrenaline, check ambulance has been called.

A

TRUE. By following the flow diagram, you would:
1) call 999
2) semi recline pt and elevate legs
3) give Intramuscular adrenaline
4) give 15/l oxygen via non-rebreather mask if hypoxic
5) give salbutamol to treat wheeze and/or stridor
6) reassess pt -> if pt remains the same/getting worse= reassess and RETREAT. CONFIRM ambulance has been called.

23
Q

Describe the method of administration of intramuscular adrenaline (7 steps).

A

1) Ask team member to prepare adrenaline for IM injection (correct dose).
2) Expose pt’s skin at the anterolateral aspect of the middle third of the thigh.
3) Place a drape over pt’s hips and thighs (protect their dignity).
4) Administer adrenaline using IM injection technique:
-remember to bring the kidney dish to the pt so that you don’t walk with the needle!
-stretch skin slightly with non-dominant hand
-with dominant hand, hold syringe like a dart, inform pt and quickly enter needle at 90 degrees to the skin until 1cm of needle is showing
-aspirate! pull back plunger, if no blood then deliver whole dose slowly. if blood appears, withdraw needle, inform pt, try again
-press cotton roll on site of injection. Don’t massage site.
5) immediately dispose of sharps in sharps bin
6) record time + dose
7) cover pt with drape to maintain pt’s dignity between doses.

24
Q

What is the rate and time interval of administration of salbutamol? (how many activations every how many mins?)

A

A rate of 2 activations every mins.

25
Q

What is the max. number of doses of salbutamol and in what timeframe?

A

10 doses max may be given over a 10-20 min period.

26
Q

Describe the administration technique of salbutamol?

A

1) Remove the protective caps from mouthpieces of spacer and inhaler.
2) Shake inhaler
3) Insert inhaler mouthpiece into spacer
4) Direct patient to exhale
5) Apply face mask, ensuring seal is effective
6) Compress canister (inhaler) and direct pt to inhale (only introduce ONE dose into spacer!)
7) Direct pt to hold breath 10s if able, or keep mask on for 5 breathing cycles if unable.

27
Q

What dose of oxygen should you administer? What mask should you use?

A

15l/min of oxygen using a non-rebreather mask.

28
Q

Describe how to set up non-rebreather mask for oxygen.

A

1) Place finger over non-rebreather valve to direct oxygen flow to bag
2) Once bag is plump, place mask over nose and mouth of pt
3) Monitor O2 sats continuously

29
Q

What are the shared characteristics between anaphylaxis and asthma?

A

-Decreased oxygen saturation
-High resp. rate
-High heart rate
-Wheeze
-Anxiety
-Confusion / reduced consciousness
-Central / peripheral cyanosis
-Hypotension (rare in life threatening asthma)

30
Q

What are the shared characteristics between anaphylaxis and Acute Cardiac Ischaemia?

A

-Decreased oxygen saturation
-High resp. rate
-High heart rate
-Anxiety
-Confusion/reduced consciousness
-Central / peripheral cyanosis
-Hypotension (rare in ACI)

31
Q

What are the shared characteristics between anaphylaxis and Hyperventilation?

A

-High resp. rate
-High heart rate
-Anxiety
-High level of respiratory effort

32
Q

List characteristics specific to anaphylaxis (11 things).

A

-Decreased oxygen saturation
-Rapid progression of symptoms
-Stridor/wheeze
-Hoarseness
-Angioedema (swelling)
-Diarrhoea
-Vomiting
-Urticarial/erythematous rash
-Central/peripheral cyanosis
-Confusion/reduced consciousness
-Hypotension

DME (5 decks)

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