Anaphylaxis Flashcards
Define:
Acute life threatening multi-system syndrome caused by a sudden release of mast cell and basophil derived products
Type 1 IgE mediated hypersensitivity
Aetiology/risk factors:
Can be immune mediated or non-immunogenic
Due to the release of histamine there is bronchospasm, increased capillary permeability and vascular tone. This leads to oedema
What are common allergens:
Peanuts Latex Drugs - penicillin Shellfish Semen Strawberries Eggs
Epidemiology:
Common
Symptoms:
Swelling of the lips and face Pruritus SOB and feeling of choking Wheeze Sweating Diarrhoea and vomiting Palpitations Hx of atopy Rash
Signs:
Tachyponea Tachycardia Cyanosis Rhinitis Swollen upper airway and eyes Erythema Conjunctival infection Urticarial rash
Investigations:
Usually clinical diagnosis
Serum tryptase, histamine and urinary metabolites of histamine may help
Following the attack:
- Skin prick test
- IgE immunoassays
Management (acute):
ABCDE
Secure the airway - 100% oxygen +/- intbate
IM 0.5mg adrenaline
IV 10mg Chlorpheniramine (anti-histamine)
Iv 100mg hydrocortisone
For bronchospasm - salbulatmol or ipatromium bromide
Maintain fluids
If still unstable then transfer to ITU - IV adrenaline +/- aminophylline and nebulised salbutamol
Management after the attack:
Move to ward + ECG monitoring Mast cell tryptase 1-6 hrs later Continue the chlorphenramine Teach how to self-inject adrenaline Skin prick tests
Complications:
Shock and organ damage due to the shock
Prognosis:
Good with prompt treatment.
