Anapyhlaxis (Complete) Flashcards
What are the main features of anaphylaxis?
SoB
Wheeze
Stridor
Facial swelling
Throat and toungue swelling
Hoarseness
Hypotension
Tacchycardia
Generalised pruritus
Widespread erythematous or urticarial rash
How is acute anaphylaxis managed?
1) Administer 500microgram adrenaline (1:1000) IM at the anterolateral aspect of the middle third of thigh
2) Repeat every 5 minutes
3) IV fluids and expert input if cardioresp symptoms persist after 2 doses of IM
4) Consider IV adrenaline infusion after expert help seeked
Anaphylaxis that persists after 2 doses of IM is considered as?
Refractory anaphylaxis
How is refractory anaphylaxis managed?
IV fluids
Expert input for IV adrenaline infusion
What is post-acute management of anaphylaxis?
Referal to allergy clinic (if new anaphylaxis)
Conservative:
2 adrenaline auto-injectors: Given on standby and as inteim until allergy clinic assesment
Patient taught on how to administer IM injection
Medicine:
Chlorphenamine (non-sedating anti-histamine)
2 adrenaline auto-injectors: Given on standby and as inteim until allergy clinic assesment
When should anaphylactic patients be reffered to allergy clinic?
If this is their first episode of anaphylaxis
What medication can be given after post-acute management if patient is still experiencing skin symptoms?
Non-sedating antihisatmines (E.g. chloramphenicol)
What patients be considered for discharge after 2 hours of symptom resolution?
Patients with fully resolved symptoms after 1 IM injection
Have been given auto-injectors and trained adequately
Have adeqaute supervision/follow-up post-discharge
What patients can only be considered for discharge after 6 hours minimum of symptom resolution?
Patient had a previous biphasic reaction
Patient required 2 doses of IM
What patients can only be considered for discharge after 12 hours minimum of symptom resolution?
> 2 IM doses
Pmx of severe asthma
Possibility of a ongoing anaphylaxis (e.g. if taking a slow-release medication that triggered allergy)
Patient presents late at night
Patient in areas where emergency access limited
