Anaphylaxis

Question 1

Type of HS

Answer 1

1

Question 2

Anaphylaxis features

Answer 2

Skin reactions: widespread urticaria, itching, flushed skin
Respiratory symptoms: swollen tongue/lips, sneezing, wheeze
Gastrointestinal symptoms: abdominal pain, nausea, vomiting, diarrhoea
Tachycardia
Hypotension

Question 3

Confirmed diagnosis of anapyalxis

Answer 3

Serum mast cell tryptase

Question 4

Management of anaphylaxis

Answer 4

• Remove trigger if possible
• ABCDE assessment
  (Administer oxygen and
  Lie patient flat and raise legs)
• Adrenaline (Adult dose is 500 micrograms IM)
• chlorphenamine

IV fluid challenge if hypotensive

When skills and equipment are available:

Manage airway
Attach patient to monitoring
Consider Intensive Care referral

Question 5

Can you discharge someone straight after they have stabilised?

Answer 5

No, can be biphasic so admit for 4-6hrs ESP IN YOUNG CHILDREN

Question 6

What should newly-diagnosed patients have

Answer 6

Counselling on to use adrenaline auto-injectors
Supply of 2 auto-injectors
Written advice
A referral to the local allergy service for follow-up

Question 7

Dose of adrenaline in children

Answer 7

Child aged under 6 months - 100-150 micrograms (0.1 to 0.15 mL)

6 months - 6 years - 150 micrograms (0.15 mL)

6-12 years - 300 micrograms (0.3 mL) 150 micrograms (0.15 mL)

> 12years - 500mcg

ADRENALINE 1:1000