Anaphylaxis

Question 1

What is the definition of anaphylaxis?

Answer 1

Airway problems: Swelling of throat and tongue.
Breathing problems: Respiratory wheeze and dyspnoea.
Circulation: Hypotension and tachycardia.

Question 2

What is the management of anaphylaxis?

Answer 2

IM adreanline every five mins in anterolateral aspect of middle third of thigh:
Age <6 months: 100-150 micrograms.
Age 6months - 6 years: 150 micrograms.
Age 6y- 12y: 300 micrograms
Adults > 12y: 500 micrograms

Question 3

Management following stabilization of anaphylaxis

Answer 3

Non-sedating oral antihistamines.
Serum tryptase within 12 hours of anaphylaxis.

Question 4

Risk stratified approach to discharge following anaphylaxis

Answer 4

Discharge after 2 hours - good response to single adrenaline, complete resolution, adequate supervision.
Minimum 6 hours after resolution - 2 doses of adrenaline needed or previous biphasic reaction.
Minimum 12 hours after resolution - >2 doses of IM adrenaline needed, presenting late at night or rural area.