Chapter 20 Immunologic Emergencies Flashcards
When an allergic reaction proceeds to life-threatening anaphylaxis, it will usually do so _____.
Quickly; within 30 seconds
The goal of invaders such as bacteria and viruses is to _____.
Use a human body as a home
Anaphylaxis caused by stinging insects is typically an allergic reaction to _____ rather than the bite or sting itself.
Injected poison
Irritating toxin
Deadly venom
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 _____.
A raised, well-defined area of the skin
Care for a victim of an immunologic emergency who is severely hypotensive should include what?
Applying high-flow oxygen
Placing the patient in a shock position
Help maintain body temperature
What sign/symptom in indicative of respiratory involvement of an allergic reaction?
Tightness in the chest or thorax
Epinephrine stimulates the _____ response, increasing blood pressure and relieving bronchospasm.
Sympathetic
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:
Monitor her closely but recall that anxiety and tachycardia are side effects of epinephrine
Anaphylaxis is most accurately defined as a(n):
Extreme allergic reaction that may effect multiple body symptoms
Urticaria is the medical term for:
Hives
The stinger from a honeybee should be:
Scraped away from the skin
What would most likely provide clues regarding the source of a patient’s allergic reaction?
The environment in which the patient was found
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?
Administer oxygen
Immediate transport
Request paramedic intercept (ALS)
What medication blocks the release of histamines?
Diphenhydramine (Benadryl)
What sound indicates swelling of the upper airway?
Stridor
The adult epinephrine auto-indicator delivers _____ mg of epinephrine, and the infant-child auto-injector delivers _____ mg.
0.3; 0.15
The effects of epinephrine are typically observed within _____ following administration.
1 minute
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:
Administer oxygen and transport her to the hospital
Epinephrine, whether made by the body or by a drug manufacturer, works rapidly to:
Raise the pulse rate and blood pressure
Inhibit an allergic reaction
Relieve bronchospasm
You should not use tweezers or forceps to remove an embedded stinger because:
Squeezing may cause the stinger to inject more venom into the wound
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?
0.15 mg
The stinger of the honeybee is _____, so the bee cannot withdraw it.
Barbed
An exaggerated immune response to any substance is called a(n) _____.
Allergic reactions
What is the substance made by the body that is released in anaphylaxis?
Leukotriene
A substance that causes an allergic reaction is called a(n) _____.
Allergen
What chemicals released in the body contribute to an allergic reaction?
Histamines and leukotrienes
What are the three most common signs of anaphylaxis?
Widespread urticaria
Angioedema
Wheezing
What are the five categories an allergen can fall into?
Food Medication Plants Chemicals Insect bites and stings
What are some common food allergies?
Shellfish Milk Soy Peanuts Treenuts Wheat Fish Eggs
What are the two most common medication allergies?
Antibiotics and NSAIDs
What are some common plant allergies?
Pollen Dust Ragweed Ryegrass Maple Oak
What are some common substances a person might experience a chemical reaction?
Latex
Soaps
Makeup
Hair dyes
Define a wheal
A raised, swollen, well-defined area on the skin
What are some signs and symptoms of insect stings or bites?
Sudden pain Redness Widespread urticaria Localized heat Swelling
What are some side effects of epinephrine?
Increased BP Increased HR Anxiety Nausea and vomiting Dizziness Headache
How do you administer epinephrine to a patient?
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
When can epinephrine be relatively contraindicated in a geriatric patient?
History of cardiac problems (heat attack, CAD)
