Anaphylaxis

Question 1

What is anaphylaxis?

Answer 1

presents with sudden onset of life-threatening airway and/or breathing and/or circulation problems (with or without skin changes) after exposure to a trigger (allergen)

Question 2

What is the presentation of anaphylaxis?

Answer 2

1. Acute onset
2. Airway swelling (angio-oedema)
3. Inspiratory stridor and hoarse voice
4. SOB
5. Wheezing, chest hyperinflation and accessory muscle use
6. Cyanosis
   Etc

Question 3

What can mimic anaphylaxis?

Answer 3

1. Carcinoid
2. Phaeochromocytoma
3. Systemic mastocytosis
4. Hereditary angioedema

Question 4

What are possible Ix for anaphylaxis?

Answer 4

1. Mast cell tryptase
2. 12-lead ECG
3. U+Es
4. ABG: elevated lactate

Question 5

What are some DDx for anaphylaxis?

Answer 5

1. Septic shock
2. Cardiogenic shock
3. Hypovolaemic shock
4. Vasovagal reaction

Question 6

What is the Intial management for anaphylaxis?

Answer 6

• CPR

- ABCDE: 100% oxygen and secure airway

Question 7

What is the medical management of anaphylaxis?

Answer 7

1. IM adrenaline 0.5mg
2. Chlorphenamine 10mg IV and Hydrocortisone 200mg IV
3. IVI e.g. 0.9% saline 500mL over 15 mins

Question 8

What are the life threatening problems in anaphylaxis?

Answer 8

Life-threatening problems

• Airway Hoarse voice stridor
• Breathing ↑work of breathing, wheeze, fatigue, cyanosis, SpO2

Question 9

What IV fluid would be used in anaphylaxis?

Answer 9

Use crystalloid Adults: 500–1000 mL Children: 10 mL/kg