Chapter 20 Immunologic Emergencies

Question 1

When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so _____.

Answer 1

Quickly; within 30 seconds

Question 2

The goal of invaders such as bacteria and viruses is to _____.

Answer 2

Use a human body as a home

Question 3

Anaphylaxis caused by stinging insects is typically an allergic reaction to _____ rather than the bite or sting itself.

Answer 3

Injected poison
Irritating toxin
Deadly venom

Question 4

At the site of the injury, signs and symptoms of an animal or insect bite or sting may include pain, localized head, and a wheal, which appears as _____.

Answer 4

A raised, well-defined area of the skin

Question 5

Care for a victim of an immunologic emergency who is severely hypotensive should include what?

Answer 5

Applying high-flow oxygen
Placing the patient in a shock position
Help maintain body temperature

Question 6

What sign/symptom in indicative of respiratory involvement of an allergic reaction?

Answer 6

Tightness in the chest or thorax

Question 7

Epinephrine stimulates the _____ response, increasing blood pressure and relieving bronchospasm.

Answer 7

Sympathetic

Question 8

After administering 0.3 mg of epinephrine via auto-injector to a 22-year-old woman with an allergic reaction, you note improvement in her breathing and dissipation of her hives. However, she is still anxious and tachycardic. You should:

Answer 8

Monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine

Question 9

Anaphylaxis is most accurately defined as a(n):

Answer 9

Extreme allergic reaction that may effect multiple body symptoms

Question 10

Urticaria is the medical term for:

Answer 10

Hives

Question 11

The stinger from a honeybee should be:

Answer 11

Scraped away from the skin

Question 12

What would most likely provide clues regarding the source of a patient’s allergic reaction?

Answer 12

The environment in which the patient was found

Question 13

A 37-year-old male is having a severe allergic reaction to penicillin. He does not have an EpiPen and your protocols do not allow you to carry epinephrine on the ambulance. How should you proceed with the treatment of this patient?

Answer 13

Administer oxygen
Immediate transport
Request paramedic intercept (ALS)

Question 14

What medication blocks the release of histamines?

Answer 14

Diphenhydramine (Benadryl)

Question 15

What sound indicates swelling of the upper airway?

Answer 15

Stridor

Question 16

The adult epinephrine auto-indicator delivers _____ mg of epinephrine, and the infant-child auto-injector delivers _____ mg.

Answer 16

0.3; 0.15

Question 17

The effects of epinephrine are typically observed within _____ following administration.

Answer 17

1 minute

Question 18

A 19-year-old female was stung multiple times on the legs by fire ants. She states that she is allergic to fire ants, but does not carry her own epinephrine. The patient is conscious and alert and complains of pain to the area of the bites. Her blood pressure is 122/70 mmHg, her pulse is 100 beats/min and strong, and her respirations are 18 breaths/min and unlabored. You should:

Answer 18

Administer oxygen and transport her to the hospital

Question 19

Epinephrine, whether made by the body or by a drug manufacturer, works rapidly to:

Answer 19

Raise the pulse rate and blood pressure
Inhibit an allergic reaction
Relieve bronchospasm

Question 20

You should not use tweezers or forceps to remove an embedded stinger because:

Answer 20

Squeezing may cause the stinger to inject more venom into the wound

Question 21

You have been called to a park where a local church is holding a potluck dinner. As you exit your ambulance, a women approaches you holding her 7-year-old son who is wheezing and having difficulty breathing. She informs you that he inadvertently ate a brownie with nuts, and he is allergic to nuts. The child has an EpiPen that contains the appropriate dose of epinephrine for a child. What dose would that be?

Answer 21

0.15 mg

Question 22

The stinger of the honeybee is _____, so the bee cannot withdraw it.

Answer 22

Barbed

Question 23

An exaggerated immune response to any substance is called a(n) _____.

Answer 23

Allergic reactions

Question 24

What is the substance made by the body that is released in anaphylaxis?

Answer 24

Leukotriene

Question 25

A substance that causes an allergic reaction is called a(n) _____.

Answer 25

Allergen

Question 26

What chemicals released in the body contribute to an allergic reaction?

Answer 26

Histamines and leukotrienes

Question 27

What are the three most common signs of anaphylaxis?

Answer 27

Widespread urticaria
Angioedema
Wheezing

Question 28

What are the five categories an allergen can fall into?

Answer 28

Food
Medication
Plants
Chemicals
Insect bites and stings

Question 29

What are some common food allergies?

Answer 29

Shellfish
Milk
Soy
Peanuts
Treenuts
Wheat
Fish
Eggs

Question 30

What are the two most common medication allergies?

Answer 30

Antibiotics and NSAIDs

Question 31

What are some common plant allergies?

Answer 31

Pollen
Dust
Ragweed
Ryegrass
Maple
Oak

Question 32

What are some common substances a person might experience a chemical reaction?

Answer 32

Latex
Soaps
Makeup
Hair dyes

Question 33

Define a wheal

Answer 33

A raised, swollen, well-defined area on the skin

Question 34

What are some signs and symptoms of insect stings or bites?

Answer 34

Sudden pain
Redness
Widespread urticaria
Localized heat
Swelling

Question 35

What are some side effects of epinephrine?

Answer 35

Increased BP
Increased HR
Anxiety
Nausea and vomiting
Dizziness
Headache

Question 36

How do you administer epinephrine to a patient?

Answer 36

1) remove the safety cap and wipe thigh with an antiseptic
2) Place the tip of the injector on the lateral part of the thigh. Push firmly and hold for 10 seconds
3) Rub the area for 10 seconds

Question 37

When can epinephrine be relatively contraindicated in a geriatric patient?

Answer 37

History of cardiac problems (heat attack, CAD)