Anaphylaxis Flashcards

1
Q

Define anaphylaxis.

A

Severe, acute, life-threatening multi system reaction to an allergen

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2
Q

What are the early features of anaphylaxis?

A

Throat/tongue swelling
Hoarseness
Wheeze
Rash

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3
Q

What are the late features of anaphylaxis?

A

Stridor
Shallow breathing
Cyanosis
Confusion (due to hypoxia)
Hypotension

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4
Q

Summarise the management of anaphylaxis.

A
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5
Q

What are the ABC symptoms of anaphylaxis?

A

Airway - swelling, hoarseness, stridor
Breathing - rapid breathing, wheeze, fatigue, cyanosis, SpO2 < 92%, confusion
Circulation - pale, clammy, low BP, faintness, drowsy/coma.

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6
Q

What are the doses of adrenaline given to different age groups?

A

< 6yo = 150mcg
6-12 yrs = 300mcg
> 12yrs and adults = 500mcg

ALL IM.

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7
Q

What fluid challenge should you give to adults and children in anaphylaxis?

A

Adults - 500-1000ml
Child - 20ml/kg

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8
Q

What type of fluids may cause anaphylaxis?

A

Colloid (these contains proteins or starches that attach water)

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9
Q

What doses of chlorphenamine and hydrocortisone can be given to adults in allergic reactions?

A

Chlorphenamine: IM/slow IV 10mg
Hydrocortisone IM/slow IV 200mg

(always 20 times higher dose of hydrocortisone than chlorphenamine except in <6mo)

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10
Q

What doses of chlorphenamine and hydrocortisone can be given to children 6-12yo in allergic reactions?

A

Chlorphenamine: IM/slow IV 5mg
Hydrocortisone IM/slow IV 100mg

(always 20 times higher dose of hydrocortisone than chlorphenamine except in <6mo)

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11
Q

What doses of chlorphenamine and hydrocortisone can be given to children <6yo in allergic reactions?

A

Chlorphenamine: IM/slow IV 2.5mg
Hydrocortisone IM/slow IV 50mg

(always 20 times higher dose of hydrocortisone than chlorphenamine except in <6mo)

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12
Q

What is the dose and dilution of adrenaline used in anaphylaxis?

A

1:1000
0.5mls IM
Repeat after 5min if no response

Also give 200mg hydrocortisone and 10mg chlorphenamine

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13
Q

What investigations should be done in anaphylaxis?

A

Mast cell tryptase - initially thwn 1-2hrs later (should be <1ng/ml but will rise to >100ng/ml in anaphylaxis)

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14
Q

How long do you monitor after anaphylaxis?

A

6-12hrs to monitor for a biphasic reaction

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15
Q

What is the management TTA after anaphylaxis?

A

Prednisolone 40mg for 3-5days
Antihistamine
Discharge with 2 EPIPENS and counsel on how to use these
GP to refer urgently to allergy/immunology clinic for further work up

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