Anaphylaxis Flashcards
What is anaphylaxis?
A serious allergic reaction that is rapid in onset and may cause death.
What is the difference between anaphylaxis and an anaphylactoid reaction?
Anaphylaxis is an IgE-mediated response, while an anaphylactoid reaction is non-IgE mediated but presents similarly.
What are the key criteria for diagnosing anaphylaxis?
Sudden onset involving skin or mucosal symptoms, sudden respiratory symptoms, sudden drop in blood pressure, or sudden gastrointestinal symptoms.
What is the lifetime prevalence of anaphylaxis in the United States?
1.6 percent based on strict clinical diagnostic criteria.
What are the most common triggers of anaphylaxis?
Food, insect stings and bites, and medications.
How is reduced blood pressure defined in adults during anaphylaxis?
Systolic BP less than 90 mmHg or a greater than 30 percent decrease from baseline.
What foods are common triggers of anaphylaxis?
Milk, egg, shellfish, finfish, peanut, tree nuts, and soy.
Why is the true global rate of anaphylaxis unknown?
Due to under-recognition by patients and caregivers and underdiagnosis by healthcare professionals.
What are some common food triggers of anaphylaxis?
Milk, egg, shellfish, finfish, peanut, tree nuts, soy.
Which insects are known to trigger anaphylaxis?
Bees, vespid, fire ants, other ants, scorpions, deer & horse flies, mosquitoes.
What are some diagnostic agents that can trigger anaphylaxis?
Contrast media, medications, antibiotics, aspirin and other NSAIDs, biological response modifiers, anti-venoms, monoclonal antibodies, blood transfusions, allergen immunotherapy.
Who are at increased risk of anaphylaxis?
Healthcare workers, children with spina bifida, patients with multiple surgeries.
What are some physical causes of anaphylaxis?
Exercise-induced, cold-induced, heat-induced.
What are the most frequent signs and symptoms of anaphylaxis?
Oral pruritus, cutaneous flushing, gastrointestinal nausea, cardiovascular faintness, respiratory congestion.
What characterizes a protracted anaphylactic reaction?
It lasts hours to days without resolving completely.
What is the most common cause of death from anaphylaxis?
Asphyxiation due to airway obstruction or cardiovascular collapse.
How predictable are the recurrent symptoms in protracted anaphylaxis?
The severity is unpredictable.
What is biphasic anaphylaxis?
Symptoms recur up to 8 hours later without further exposure to the trigger.
What is a protracted course of anaphylaxis?
A reaction that lasts hours to days without resolving completely.
What percentage of anaphylactic reactions are biphasic?
Up to 23%.
What should patients be informed about after being discharged following anaphylaxis?
The possibility of recurrent symptoms for up to three days.
What is the primary treatment for all anaphylactic episodes?
Epinephrine.
What is the recommended dose of epinephrine for adults and children weighing 30 kg or more during anaphylaxis?
0.3 to 0.5 mg intramuscularly in the thigh, repeated every 5 to 10 minutes as necessary.
When should serum tryptase be measured in relation to an anaphylactic reaction?
Within 15 minutes to 3 hours of the reaction.
What is the significance of a positive serum tryptase test?
It helps to confirm the clinical diagnosis.
How should epinephrine be administered to children weighing less than 30 kg during anaphylaxis?
0.01 mg/kg intramuscularly or subcutaneously in the thigh, up to a maximum of 0.3 mg per injection, repeated every 5 to 10 minutes as necessary.
What are the rapid progression symptoms of anaphylaxis?
Respiratory distress, vomiting, abdominal pain, hypotension, dysrhythmia, and chest pain.
What is the first-line treatment for anaphylaxis?
Intramuscular epinephrine in the mid-outer thigh, repeated every 5 to 15 minutes as needed.
What additional treatments are recommended if symptoms do not respond to epinephrine injections?
Prepare IV epinephrine for infusion, place the patient in a recumbent position, provide oxygen, administer normal saline rapid bolus, and consider albuterol for bronchospasm.
What adjunctive therapies can be considered during anaphylaxis management?
H1 antihistamine (diphenhydramine), H2 antihistamine (ranitidine), and glucocorticoid (methylprednisolone).
What monitoring is essential for patients receiving IV fluid resuscitation for severe hypotension or shock?
Continuous noninvasive hemodynamic monitoring, pulse oximetry, and urine output monitoring.
What should be done immediately after discharge from the ED following anaphylaxis?
Fill the epinephrine prescription.
What are the 3 R’s of an anaphylaxis emergency action plan?
Recognize symptoms early, respond quickly, review the cause.
What should be done for patients on beta-blockers who do not respond to epinephrine?
Administer glucagon 1 to 5 mg IV over 5 minutes, followed by an infusion of 5 to 15 mcg/minute.
What is the common issue regarding the knowledge of epinephrine usage among healthcare professionals and patients?
Inadequate knowledge about outpatient use, with many unaware of different dose formulations and proper usage techniques.
What are the key steps to take during an anaphylactic reaction?
Administer epinephrine, activate EMS (911), and notify emergency contacts.
Who is at risk for anaphylaxis?
Anyone, especially those allergic to certain foods, insect stings, latex, or medications.
What is the recommended dose of epinephrine for adults and children over 30 kg?
0.3 to 0.5 mg administered intramuscularly in the thigh, repeated every 5 to 10 minutes as necessary.
What should be avoided when searching for the etiology of anaphylaxis?
Random screening tests.
When can anaphylaxis occur?
Within minutes of exposure to an allergen.
What are the signs that indicate anaphylaxis?
Several symptoms occurring simultaneously, such as itching, hives, difficulty breathing, vomiting, dizziness, or shock.
Where can anaphylaxis occur?
Anywhere, including home, restaurants, schools, and transportation.
Why is follow-up necessary after an anaphylactic episode?
To confirm the trigger and implement long-term preventive strategies.
