Anaphylaxis

Question 1

treatment of anaphlaxysis

Answer 1

• Administer adrenaline if the patient is showing systemic signs of anaphylaxis:
  a) Administer 0.5 mg IM for an adult.
  b) See the paediatric drug dose tables for the IM dose for a child.
• Gain IV access.
• Administer 0.9% sodium chloride IV if the patient has signs of hypovolaemia or poor perfusion:
  a) 1 litre for an adult.
  b) 20 ml/kg for a child.
  c) Repeat as required.

Question 2

Transport should usually be to an ED, unless the patient:

Answer 2

a) Has previously had anaphylaxis, and
b) Has rapidly improved with a single dose of adrenaline IM, and
c) Is being taken to a primary care facility with the capacity to observe them
for several hours.

Question 3

It is usually characterised by skin features of systemic inflammatory mediator release (urticaria, itch or flush, swollen lips and/or tongue) plus involvement of one or more of the following systems:

Answer 3

ū The respiratory system with any of the following: dyspnoea, chest or throat tightness, wheeze or stridor.
ū The cardiovascular system with any of the following: hypotension, poor perfusion, fainting, collapse or altered level of consciousness.
ū The gastrointestinal system with any of the following: severe nausea, vomiting, abdominal pain or diarrhoea.

Question 3

Angioedema is a condition that results in

Answer 3

intermittent, unpredictable and isolated swelling of the mouth and/or face. It often occurs in patients taking aspirin or an angiotensin converting enzyme (ACE) inhibitor and may occur following fibrinolytic therapy.
* Angioedema may respond to nebulised adrenaline.