Anaphylaxis Flashcards
1
Q
What is the first line treatment for anaphylaxis(what do you need to do first?)
A
- Oxygen
- Adrenaline(0,01mg/kg IM)
- IV fluids
2
Q
What is the second line stuff you should do for anaphylaxis?
A
- H1 antihistamine
- Bronchodilators
- corticosteroids
3
Q
What is the pathophysiology of anaphylaxis?
A
- It is a type 1 hypersensitivity reaction
- IgE mediated
- causing mast cells to degranulate and release histamine, serotonin and bradykinins if they come into contact with antigens
4
Q
What are the signs and symptoms of anaphylactic shock?
A
- CVS: hypotension-vasodilation
- RESP: angiooedema and bronchospasm
- skin: rash and flushing
- GIT: nausea, vomiting, diarrhoea and abdominal discomfort
5
Q
What are the clinical manifestations of anaphylaxis in patients under general anesthesia?
A
- bronchospasm- there will be changes on capnography tracing
There will be decreased tidal volume, increased airway pressure - Hypotension: BP might be so low we cannot trace it
6
Q
What are the clinical manifestations of anaphylaxis in patients under spinal?
A
- bronchospasm- patients complains of tight chest, difficulty breathing and swallowing and stridor and voice changes occur
- hypotension-untraceable
7
Q
Why must we wait before we give IV antihistamine?
A
-It is said to cause cardiac instability and so it can make things worse if the patient is not yet stable cardiacally and we give antihistamine
8
Q
Why must we not use MgSO4 in anaphylaxis?
A
-It is excellent for bronchospasm but it cause hypotension
9
Q
What is the management of anaphylaxis?
A
- Stop the trigger-antibiotics, latex, muscle relaxants
- Give 100% oxygen
- Intubate the patient to protect the airway
- Give adrenaline- 50-100 mcg boluses(start infusion later
- Give IV fluid- crystalloid or colloid 10-20ml/kg
- Other drugs-salbutamol(B-blocker)
ranitidine, phenylephrine(vasopressor), glucagon
