ANAPHYLAXIS

Question 1

WHAT IS AN ANAPHYLAXIS?

Answer 1

-severe and potentially life-threatening reaction to a trigger, such as an allergy.

Question 2

WHAT ARE THE COMMON TRIGGERS FOR ANAPHYLAXIS?

Answer 2

1) insect bites/ sting
2) food
3) medication

Question 3

HOW LONG DOES IT TAKE FOR AN ANAPHYLAXIS REACTION TO OCCUR?

Answer 3

within minutes

Question 4

WHAT ARE THE CLINICAL FEATURES OF AN ANAPHYLAXIS REACTION?

Answer 4

1) pruritus - itchy skin
2) urticaria - red, raised, itchy skin rash
3) angioedema
4) hoarseness
5) progress to stridor (due to narrow airways)
6) bronchial obstruction
7) wheeze
8) chest tightness from bronchospasm

Question 5

WHAT IS ANGIOOEDMA?

Answer 5

• area of swelling of the lower layer of skin and tissue just under the skin or mucous membranes.
• the swelling may occur in the face, tongue, larynx, abdomen, or arms and legs.

Question 6

WHAT IS STRIDOR?

Answer 6

• high-pitched, wheezing sound caused by disrupted airflow

Question 7

WHAT IS THE MANAGEMENT FOR ANAPHYLAXIS?

Answer 7

1) Remove trigger
2) Maintain airway - 100 02 SATS
3) Intramuscular adrenaline 0.5 mg (Repeat every 5 mins as needed to support CVS)
4) IV hydrocortisone 200mg
5) IV chlorpheniramine 10 mg - antihistamine
6) If hypotensive: lie flat and fluid resuscitate
7) Treat bronchospasm: NEB salbutamol
8) Laryngeal oedema: NEB adrenaline

Question 8

WHAT IS THE PATHOPHYSIOLOGY OF ANAPHYLAXIS REACTION?

Answer 8

immunoglobulin E (IgE) binds to the antigen (the foreign material that provokes the allergic reaction). Antigen-bound IgE then activates mast cells and basophils. This leads to the release of inflammatory mediators such as histamine. These mediators subsequently increase the contraction of bronchial smooth muscles, trigger vasodilation, increase the leakage of fluid from blood vessels, and cause heart muscle depression