ANAPHYLAXIS

Question 1

What are the presenting signs and symptoms of an anaphylaxis attack (4)

Answer 1

Marked upper airway oedema and bronchospasm
Tachycardia (above 110) and increased RR
Abdominal pain, vomiting, diahorrea, SENSE OF IMPENDING DOOM
Flushing but pallor may also occur

Question 2

What is the ABCDE approach of an anaphylaxis attack

Answer 2

A - Stridor, wheezing
B - increased respiratory rate (as high as 30), decreased Sp02, rapid shallow breaths
C - Drastically decreased BP due to vasodilation, increased CRT, Tachycardia, bounding pulse
D - ACVPU - A but with impending sense of doom, glucose is N/A
E - flushing, hives/rash, angingoedema of lips, nose, tongue, stomach cramps, urinary incontinence, bowel incontinence, vominting/nausea.

Question 3

What is the management of anaphylaxis ? (7)

Answer 3

• phone 999 and state anaphylaxis
• remove the source (if known)
• secure pts airway and try to lay patient in supine position with feet raised to restore BP
• administer 1:1000 adrenaline - 0.5mg
• 02 - 15 ltrs/min via non rebreather mask
• if pt has auto-injector then use this FIRST before using adrenaline on emergency kit
• repeat after 5 mins if required

Question 4

What are the child dosages for adrenaline in an anaphylactic shock?

Answer 4

12-17yrs - 0.5mg same as adult dose
6-11yrs - 0.3mg
6months to 5yr - 0.15mg

Question 5

What is the main benefit of adrenaline ?

Answer 5

it is a VASOCONSTRICTOR. this means that is SQUEEZES the peripheral vessels to ensure that blood and fluid is forced back towards the head.