Anaphylaxis and Medical Errors Flashcards
1
Q
What is anaphylaxis
A
- An acute allergic reaction to an antigen (e.g. bee sting) to which the body has become hypersensitive
2
Q
Describe what happens in the first exposure to an allergen
A
- Allergen
- causes TH1 to be released
- causes TH2 to be release d
- causes interleukins
- produce IL4
- produces B cells
- IgE is produced from B cells
3
Q
describe what happens in the second exposure to an allergen
A
- IgE antibody is produce
- bridging takes place
- produces basophils and mast cells
4
Q
What happens when basophils and mast cells degranulate
A
- they vasoactive and lead to mediator and cytokine release
- this causes release of histamine, leukotrienes, PgD2, platelet activating factor, complement system, eosinophils and neutrophil chemotactic factors, nitric oxide and tryptase
5
Q
What does histamine cause to happen
A
- tachycardia
- headaches
- mucus secretion
- rhinorrhea
- bronchospasm
6
Q
What does nitric oxide cause
A
- bronchospasm
- vasodilation
7
Q
What does PgD2 do
A
- bronchospasm
- pain
- oedema
- vasodilation
8
Q
What does the complement system do
A
- vasodilation
- bronchospasm
9
Q
what does tryptase do
A
- proteolysis
10
Q
What does platelet activating factor
A
- oedema
- vasodilation
- bowel contraction
- bronchospasm
- thrombi and microthrombi
11
Q
How do you manage an anaphylactic reaction
A
- ABCDE
- diagnosis - acute onset of illness, life-threatening airway and breathing or circulation, usually skin changes
Call for help
- lie patient flat
- raise the patients legs
Adrenaline
12
Q
how and how much adrenaline should you give
- adult or child more than 12 years
- child 6-12 years
- child 6 months to 6 years
- child less than 6 months
A
- Adrenaline (give IM unless experienced with IV adrenaline), IM doses of 1:1000 adrenaline (repeat after 5 minutes if no better)
- Adult = 500 micrograms IM
- Child more than 12 years = 500 micrograms IM
- child 6-12 years - 300 micrograms IM
- child less than 6 yers = 150 micrograms
13
Q
what levels of chlorphenamine should you give
- adult or child more than 12 years
- child 6-12 years
- child 6 months to 6 years
- child less than 6 months
A
- adult or child more than 12 years = 10mg
- child 6-12 years = 5mg
- child 6 months to 6 years - 2.5mg
- child less than 6 months - 250 micrograms/kg
14
Q
how much hydrocortisone should you give
- adult or child more than 12 years
- child 6-12 years
- child 6 months to 6 years
- child less than 6 months
A
- adult or child more than 12 years = 200mg
- child 6-12 years = 100mg
- child 6 months to 6 years = 50mg
- child less than 6 months = 25mg
15
Q
what should you do post anaphylaxis
A
- consider 3 days of anti-histamines and oral steroids
- observe on HDU for at least 6 hours then review by a senior clinical
- report drug reactions to the MHRA
