Anaphylaxis Flashcards

1
Q

List the examples of possible allergens provided under this guideline.

A

Food, bites/stings, medications or unknown allergen.

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2
Q

What is the ideal site for IM Adrenaline administration?

A

Anterolateral mid-thigh due to improved absorption.

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3
Q

What note is made about IM vs. IV Adrenaline?

A

All patients should receive initial IM Adrenaline regardless of presentation, with IV Adrenaline being reserved for impending cardiac arrest/extremely poorly perfused patients.

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4
Q

Which patients may be persistently unresponsive to IM Adrenaline? What alternative treatment pathway can be considered for them?

A

Patients on beta blockers.

Consult for 1-2 IU of IM or IV Glucagon.

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5
Q

Deaths from anaphylaxis are far more likely to be associated with…?

A

Delay in treatment than inadvertent Adrenaline administration.

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6
Q

What must be done for all anaphylaxis patients?

A

Transport to hospital, irrespective of symptom resolution or severity. Monitoring for 4 hours is recommended following treatment.

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7
Q

What supplementary inhaled therapies may also benefit in anaphylaxis?

A

Salbutamol - for persistent bronchospasm

Nebulised Adrenaline - for persistent upper airway oedema and stridor

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8
Q

If pt has self-injected EpiPen and symptoms have corrected prior to paramedic arrival, do they require transport?

A

Yes.

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9
Q

Outline the R.A.S.H criteria.

A

Sudden onset of symptoms (minutes to hours)
AND
R - respiratory distress (SOB, wheeze, stridor, cough)
A - abdominal symptoms (N or V, cramps, diarrhoea)
S - Skin/mucosal symptoms (hives, itch, flush, swelling)
H - Hypotension or altered conscious state
OR
Isolated hypotension of <90 following exposure to a known antigen.

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10
Q

If a patient refuses Tx post-anaphylaxis, what steps must be taken?

A
  1. Strongly encouraged to consent to transport
  2. Advised of the risk and consequences (incl. death)
  3. Left with a responsible third party
  4. Given clear instructions on when to call back
  5. Advised to follow up with their LMO
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11
Q

If RASH criteria not met, what is the management?

A
  1. BLS
  2. Continually re-assess
  3. Consider Tx for observation and further Mx
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12
Q

If RASH criteria met and Anaphylaxis/Severe Allergic Reaction confirmed, outline the management.

A
  1. Monitor cardiac rhythm
  2. Do not allow pt to stand or walk
  3. Adrenaline
    - 500mcg IM, rpt at 5 min intervals
    - 300mcg IM, rpt at 5 min intervals
    Until satisfactory results or side effects occur
  4. 10-15L/min of O2
  5. Salbutamol 10mg via neb. mask (if bronchospasm)
  6. Adrenaline 5mg via neb. mask (if U.A oedema)
  7. Normal Saline up to 40ml/kg titrated to pt response, consult for further fluids/ or admin further 20ml/kg if no consult available (only if less than adequate perfusion)
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13
Q

What is the indication for Normal Saline under this guideline and what is the administration?

A

Less than adequate perfusion.

Up to 40ml/kg, consult for further or if no consult available, admin further 20ml/kg (max 60ml/kg).

Titrate to pt response.

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14
Q

What is purpose of an early MICA request in these patients?

A

IV Adrenaline, possible intubation.

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15
Q

Irrespective of symptom resolution, what is the further management?

A
  1. Tx
  2. Reassess en route
  3. Monitor for recurring symptoms
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