Anaphylaxis Flashcards
Common agents known to cause anaphylaxis
Antibiotics (penicillin), aspirin, NSAIDs, ACEIs, food (peanuts, egg, seafood), insect stings, hereditary C1 esterase inhibitor, idiopathic, latex, biological fluids
Airway problems of anaphylaxis
Lip and tongue swelling/angioedema, nasal congestion, sneezing, tightness of throat, hoarse voice, stridor
Breathing problems of anaphylaxis
Tachypnoea, bronchospasm, wheeze, increased mucous excretions, exhaustion, confusion, cyanosis, respiratory arrest
Circulatory problems in anaphylaxis
Hypotension, tachycardia, arrhythmia, MI, cardiac arrest
Neurological problems in anaphylaxis
Confusion, agitation, loss of consciousness
Skin and muscosal problems in anaphylaxis
Urticaria, erythema, pruritis
GI problems in anaphylaxis
Cramps, nausea, vomiting, diarrhoea
Anaphylaxis is likely when what 3 criteria are met
Acute onset of illness and sudden progression
Skin/mucosal changes
Life threatening airway/breathing/circulation problems
Differentials of anaphylaxis
Asthma, septic shock, vasovagal episode, panic attack, breath holding spell, systemic mast cell disorders, idiopathic urticaria or angioedema
When should mast cell tryptase levels be taken
As soon as resus started, 1-2 hours after symptoms onset, 24 hours later
2 Key steps in emergency treatment of anaphylaxis
Adrenaline and fluid challenge
What is the dose of adrenaline that should be administered
1mh/ml (1:1000)
Dose administered for adult or child >12 years
500 micrograms IM (0.5 mL of 1 mg/ml
Dose administered for child aged years 6-12
300 micrograms (0.3 mL)
Dose administered for infant aged 6 months - 6 years
150 micrograms (0.15 mL)
What is involved in a fluid challenge
Crystalloid fluid bolus - adults 500-1000ml IV
How long after first dose of adrenaline can another be given
5 minutes
What happens after 2 doses of adrenaline have been given and there is no improvement
It is considered refractory anaphylaxis and requires an IV infusion of adrenaline
What is the treatment of anaphylaxis due to C1 esterase inhibitor deficiency
C1 esterase inhibitor concentrate or fresh frozen plasma
