Anaphalaxis Flashcards
what do you look for in anaphalaxis?
- sudden onset
- rapid progression
- life threatening (airway, breathing, circulation)
- skin or mucosal changes
what to do if patient has an anaphalaxis reaction?
- 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
what does of adrenaline do you give for a child less than 6 months
0.1-0.15 ml (100-150 micrograms)
what dose of adrenaline given to pt less than 6 years
0.15ml (150 micrograms)
what dose of adrenaline do we give to a pt aged 6-12yrs
0.3ml (300 micrograms)
what dose of adrenaline do we give a pt aged more than 12 yrs
0.5ml (500 micrograms)
what do we do if pt starts to get better in reassessment
monitor ABCDE
- complete incident report
what do we do if the pt remains the same of gets worse
reassess and retreat as per algorithm and confirm ambulance is called
- complete incident report
what are the reported symptoms for Airway
itching
difficulty swallowing
what are the clinical findings of Airway
stridor / wheeze/ hoarse voice
swelling (tongue or soft palate
what are the reported symptoms of Breathing
cough
shortness of breath
runny nose
what are the clinical findings for breathing
high respiratory rate
oxygen saturations below 94%
what are the reported symptoms of circulation
dizziness
visual disturbances
pallor
what are the clinical findings for circulation
high heart rate
low blood pressure
high capillary refill time
what are the symptoms for disability
agitation/fear
anxiety
what are the clinical finding for disability
reduced conciousness
fatigue
confusion
what are the symptoms for exposure
itching
sweaty
cold peripheries
what are the clinical findings for exposure
rash
flushed appearance
cyanosis
angiodema
what are the additonal symptoms of anaphalaxis reaction
nausea
vomiting
abdominal pain
are all skin or mucosal changes anaphalaxis reaction
no, only 20% anaphalaxis reaction have skin/mucosal changes
True of False: Administration of adrenaline may be repeated at 2 minute intervals.
FALSE
Administration of adrenaline may be repeated at 5 minute intervals.
True or False: If no improvement after TWO doses of adrenaline, check ambulance has been called.
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.
Describe the method of administration of intramuscular adrenaline (7 steps).
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.
What is the rate and time interval of administration of salbutamol? (how many activations every how many mins?)
A rate of 2 activations every mins.
