Anaphylaxis

Question 1

The therapeutic effects of epinephrine in anaphylaxis are (list 3)

Answer 1

• Reduce angioedema (lips tongue airway)
• Increase blood pressure and circulation
• Bronchodilate

Question 2

Adult dosage of epinephrine in anaphylaxis is ____ (range) mg, q ___ minutes x ___

Answer 2

0.3 - 0.5 mg 1:1000 IM, q 5 minutes x 3

Question 3

PCPs may deliver a maximum of ___ doses of IM epinephrine in anaphylaxis

Answer 3

3

Question 4

__________ may be delivered as an adjunct to care in anaphylaxis only after administration of epinephrine

Answer 4

salbutamol

Question 5

In anaphylaxis, hypotension should be corrected when SBP drops ____ (range) mm Hg

Answer 5

< 90 mm Hg

Question 6

Hypoperfusion/hypotension in anaphylaxis may be corrected by fluid challenge with N/S up to _____ mL, assessing BP and lung fields every 500mL, targeting a SBP of 90 mm Hg

Answer 6

2000 mL

Question 7

Hypoperfusion/hypertension in anaphylaxis may be corrected by fluid challenge with N/S up to 2000 mL, assessing BP and lung fields every _____ mL, targeting a SBP of 90 mm Hg

Answer 7

500 mL

Question 8

Primary medical interventions for hypoxia/hypoxemia seen in anaphylaxis include: __________, __________, and __________

Answer 8

oxygen, epinephrine, and salbutamol

Question 9

Pediatric dosage of epinephrine in anaphylaxis treatment is ___ mg / kg to a maximum of ___ mg

Answer 9

0.01 mg / kg to a maximum of 0.5 mg

Question 10

Hives in anaphylaxis usually last for _________ (hours / days)

Answer 10

Hives in anaphylaxis never last for more than 4 hours

Question 11

Patients with anaphylaxis will __________ (often / rarely) have a history of previous anaphylaxis.

Answer 11

Often

Question 12

_________ reactions are anaphylactic reactions that develop 4 - 12 hours after exposure, usually due to ingestion

Answer 12

Late – phase or biphasic reactions

Question 13

Patients with suspected anaphylaxis should be positioned _________

Answer 13

supine with legs elevated, except in those who cannot tolerate supine positioning due to respiratory distress

Sitting upright or standing has been associated with fatal allergic reactions.​

Question 14

In extremely rare cases, paramedics responding to an anaphylaxis patient who is prescribed ace inhibitors / beta blockers and is not responsive to epinephrine may contact EPOS to discuss treatment with __________

Answer 14

Glucagon

In addition, in extremely rare circumstances, adults prescribed ACE inhibitor and/or Beta Blocker medications may present with hypotension not responsive to IV fluids and standard IM EPINEPHrine. There is some literature to support IV glucagon in this scenario. This is intended primarily for CCP/ITT as other therapies will also be given that is within their scope and includes a mandatory EPOS consultation. Other license levels may discuss with EPOS if there are unique circumstances for which the medic may think the patient might benefit, as long as standard therapy has been administered.