Chapter 21 Flashcards

1
Q

Abdominal cramping

A

A common gastrointestinal symptom associated with food-induced anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Actions of epinephrine

A

Epinephrine mimics the responses of the sympathetic nervous system, constricting blood vessels to improve blood pressure and reducing leakage from capillaries, while relaxing smooth muscle in bronchioles to improve breathing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Activation of auto-injector

A

Activated by pressing it against the patient’s thigh, releasing a spring-activated plunger.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute circulatory compromise

A

A reaction with edema of the bronchiole and/or edema of the upper airway, including falling blood pressure, weak pulse, and poor tissue perfusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute respiratory compromise

A

A reaction with normal bronchiole and normal airway resulting in an occluded upper airway and labored respirations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Administration of epinephrine

A

To administer the epinephrine by auto-injector, obtain an order from medical direction, obtain the auto-injector, check the medication, remove the safety cap(s), place the tip against the lateral aspect of the patient’s thigh, push the injector firmly, hold in place until all medication is injected, dispose of the injector in a biohazard container, and record the administration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Adult dose of epinephrine

A

The dosage for adults is typically 0.3 mg or greater.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Advanced life support (ALS)

A

May be needed for advanced airway control and further medication administration in severe cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Agitation

A

A state of anxiety or restlessness that may be observed in patients experiencing anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Airway compromise

A

Swelling of the tissues lining the larynx that can obstruct airflow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Airway obstruction signs

A

Indicators such as stridor, hoarseness, or crowing sounds that suggest significant swelling of the airway.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Allergens

A

A specific type of antigen that causes an abnormal response by the immune system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Allergic Reaction

A

A misdirected and excessive response by the immune system to an allergen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Allergic reaction vs. side effect

A

A side effect of a medication is not the same as an allergic reaction, such as nausea after codeine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Alpha properties of epinephrine

A

Causes the vessels to constrict and regulates the amount of vasoconstriction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Altered mental status (AMS)

A

Changes in mental function that may occur during severe allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anaphylactic reaction

A

A severe allergic reaction that can cause weak and rapid pulse, edema, and respiratory distress.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Anaphylactic Reaction Criteria for Epinephrine Administration

A

Criteria that require aggressive emergency care and administration of epinephrine when specific conditions are met.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Anaphylactic Shock

A

A life-threatening response characterized by cardiovascular collapse and hypotension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anaphylactic Shock

A

A condition characterized by hypoperfusion or shock in conjunction with other signs and symptoms of anaphylaxis. (AKA Anaphylactic Reaction, Anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Anaphylactoid reaction

A

A non-IgE mediated reaction that can occur the first time an antigen is introduced into the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Anaphylactoid reaction

A

A reaction where chemical mediators are released from mast cells and basophils the first time the antigen is introduced into the body without prior sensitization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Angioedema

A

Swelling of the skin and other tissues such as the lips and tongue, often associated with allergic reactions, can be drug induced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Antibodies

A

Proteins that search for the antigen, combine with it, and help to destroy it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Antigen

A

A foreign substance that induces an immune response, including the production of IgE antibodies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Antihistamine

A

A medication, such as diphenhydramine (Benadryl), used to treat mild allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Assessment for Anaphylaxis

A

1 Evaluate for patent airway and presence of oropharyngeal edema. 2 Auscultate for wheezing and assess level of respiratory effort. 3 Assess for adequacy of perfusion. 4 Assess for presence of signs and symptoms of anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Asthma

A

A chronic respiratory condition that increases the risk of severe allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Auvi-Q

A

An auto-injector for epinephrine that is about the size of a credit card and has audio instructions for the injection process.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Bag-valve-mask device

A

A device used to deliver positive pressure ventilation, which may be harder to compress in obstructed airways.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Basophils

A

White blood cells that circulate in the blood and are involved in the immune response, particularly in allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Bees

A

Includes honeybees and bumblebees, which are part of the Hymenoptera family.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Beta properties of epinephrine

A

Increases the heart rate, force of contraction of the heart, and the speed at which the electrical impulses are carried through the heart; causes bronchiole smooth muscle to dilate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Beta-Blocker

A

A medication that may limit the response to epinephrine in patients experiencing anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Biphasic Anaphylactic Reaction

A

Occurs when initial symptoms resolve and a second reaction occurs approximately 1-72 hours later.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Bites and stings

A

Insect bites or stings that can lead to anaphylaxis, particularly from yellow jackets or wasps.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Breathing assessment

A

If breathing is inadequate, administer PPV with oxygen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Bronchial Constriction

A

Narrowing of the air passages in the lungs, which can be a symptom of anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Bronchoconstriction

A

A life-threatening response in anaphylaxis characterized by the tightening of the muscles around the airways, putting pressure on the alveoli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Capillaries

A

Small blood vessels that facilitate the exchange of substances between the blood and tissues, including the transport of chemical mediators.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Capillary permeability

A

The ability of capillaries to allow substances to pass through their walls, which increases during anaphylaxis leading to fluid leakage. Can lead to shock.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Cardiovascular Collapse

A

Cardiovascular collapse may occur abruptly, without the prior development of skin or respiratory symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Cardiovascular collapse and poor perfusion

A

Tachycardia, hypotension, syncope, light-headedness, general weakness, syncope, and chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Cardiovascular System

A

Tachycardia (increased heart rate), hypotension (decreased blood pressure), irregular pulse, absent radial pulse (severe shock)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Central Nervous System

A

Another body system that may exhibit signs and symptoms during an anaphylactic reaction. Increased anxiety, light-headedness, unresponsiveness, disorientation, restlessness, seizures, headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Chemical mediators

A

Substances released from mast cells and basophils that cause a cascade of events leading to anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Chemical Substances

A

Substances released during an anaphylactic reaction that affect the entire body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Chest Pain

A

A symptom that may occur in patients experiencing anaphylaxis, sometimes alongside dyspnea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Chronic obstructive pulmonary disease (COPD)

A

A group of lung diseases that block airflow and make it difficult to breathe, increasing the risk of severe allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Circulatory compromise

A

A state where blood circulation is inadequate, which can occur during severe allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Common allergens causing anaphylaxis

A

Foods like peanuts, nuts, milk, eggs, shellfish, and certain medications.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Common causes of anaphylactic reaction

A

Medications, idiopathic causes, and various allergens including food and insect stings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Contact (absorption)

A

The route where the antigen is absorbed through the skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Contraindications for epinephrine

A

There are no contraindications for the administration of epinephrine in a life-threatening anaphylactic reaction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Criteria 1 for epinephrine administration

A

Sudden onset (minutes to several hours) with involvement of skin, mucosal tissue, or both (generalized hives, itching, flushing, redness, edema to face, lips, tongue, and uvula) and at least one of the following: signs or symptoms of respiratory involvement and compromise (e.g., dyspnea, wheezing, cough, stridor, hypoxemia), hypotension—adult SBP, pediatrics; see SBP chart below associated with end-organ dysfunction (syncope, incontinence, hypotonia).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Criteria 2 for epinephrine administration

A

Two or more of the following occurring rapidly (minutes to several hours) after exposure to a likely allergen or other trigger for a patient: involvement of skin, mucosal tissue, or both (generalized hives, itching, flushing, redness, edema to face, lips, tongue, and uvula), sudden respiratory compromise (dyspnea, wheezing, cough, stridor, hypoxemia), sudden hypotension—adult SBP, pediatrics; see SBP chart below associated with end-organ dysfunction (syncope, incontinence, hypotonia), sudden gastrointestinal symptoms (crampy abdominal pain, vomiting, diarrhea).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Criteria 3 for epinephrine administration

A

Reduced SBP after exposure to a known allergen for that patient within minutes to several hours: infants and children a low systolic BP age-specific lower limit of normal or decrease in SBP; adults systolic BP or decrease from the person’s baseline systolic BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Cutaneous manifestations

A

Signs such as urticaria or mucocutaneous swelling that are commonly associated with anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Cyanotic skin

A

Skin that appears blue due to inadequate breathing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Desensitization

A

A medical process that may reduce the likelihood of an anaphylactic reaction upon subsequent exposures to the same antigen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Diminished breath sounds

A

A sign of inadequate respiration, indicating the need for immediate positive pressure ventilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Disposal of auto-injector

A

Dispose of the device in a biohazard puncture-resistant container.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Distinguishing reactions

A

EMTs must differentiate between systemic anaphylactic reactions and local allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Epinephrine Dosage for adults

A

0.3 milligram for an adult.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Dosage for children

A

0.15 milligram for a child.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Duration of epinephrine’s effectiveness

A

Short, only approximately a few minutes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Dyspnea

A

Shortness of breath, which can occur before other signs and symptoms in anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Early transport

A

Initiate transport of the patient without unnecessary delay; continued assessment can be done en route.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Edema

A

Swelling caused by excess fluid trapped in the body’s tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Emergency care algorithm

A

A systematic approach to managing anaphylactic reactions, including assessing mental status and administering oxygen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Emergency care for severe anaphylaxis

A

Requires immediate and aggressive intervention by EMTs, including maintaining a patent airway.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

EMS unit protocol for epinephrine

A

If no epinephrine is prescribed or carried on the EMS unit, transport and reassess.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

End organ dysfunction

A

Symptoms indicating that organs are not receiving enough blood flow, such as syncope or incontinence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Endotracheal intubation

A

The placement of a tube in the trachea to facilitate breathing, usually performed by an advanced life support (ALS) team.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Epinephrine

A

A medication administered in severe systemic anaphylactic reactions, especially when hypotension or respiratory distress is present.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Epinephrine auto-injector

A

A device typically used to administer epinephrine, though some systems may use an ampule and syringe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Epinephrine injection

A

Should be reassessed for effectiveness in reversing life-threatening conditions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Epinephrine’s antihistamine effect

A

Reduces the effects of histamine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Epinephrine’s effect on bronchioles

A

Causes bronchodilation, reversing bronchoconstriction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Epinephrine’s effect on capillaries

A

Causes vasoconstriction and tightens the capillaries, reversing the vasodilation and increased capillary permeability experienced by the anaphylactic patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

EpiPen

A

A disposable delivery system for self-administration of epinephrine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

EpiPen auto-injector expense

A

Because of the excessive expense of the EpiPen auto-injector, some EMS units and patients have begun to carry epinephrine in a vial that requires manual administration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Exercise-induced anaphylaxis

A

A condition where physical activity can exacerbate anaphylactic reactions, especially after eating certain foods.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Eye: Conjunctivitis

A

Red and itchy eyes, increased tears, swelling to eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Fire ants

A

Their bite is similar to that of a bee or hornet and can cause severe allergic reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Flushed or red skin

A

Swelling to the face, lips, neck, hands, feet, and tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Food-induced anaphylaxis

A

Anaphylaxis triggered by exposure to food allergens, which may not always present with cutaneous symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Gastrointestinal symptoms

A

Symptoms such as nausea, vomiting, and diarrhea that can occur during food-induced anaphylaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Generalized Signs and Symptoms

A

Itchy, watery eyes, runny or stuffy nose, sense of impending doom, complaints of ‘not feeling well’, general weakness or discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Genitourinary System

A

A body system that can also be involved in the signs and symptoms of anaphylaxis. Urinary incontinence, vaginal bleeding, and pelvic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Granules

A

Small particles within mast cells and basophils that contain chemical mediators and are released during an allergic reaction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

High index of suspicion

A

The need for thorough assessment in potential allergic reaction patients, considering various factors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Histamine

A

The primary chemical mediator released from mast cells and basophils, causing bronchoconstriction, vasodilation, and increased capillary permeability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

History Taking

A

The process of obtaining information from the patient or bystanders to assess the situation, especially if the patient is unresponsive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Hives

A

Raised red blotches on the skin, usually accompanied by severe itching, and are a hallmark sign of an allergic reaction. Most common complaint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Hymenoptera

A

The family of insects that account for the majority of severe allergic reactions and anaphylaxis related to insect bites.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Hymenoptera venom

A

Venom from insects such as bees and fire ants that can cause severe allergic reactions.

98
Q

Hypersensitivity

A

A condition that develops during the first exposure to an antigen, leading to an anaphylactic reaction upon subsequent exposures.

99
Q

Hypoperfusion

A

A state of inadequate blood flow to the organs, which can occur during anaphylactic shock.

100
Q

Hypotension

A

Low blood pressure, defined as less than 90 millimeters of mercury systolic blood pressure in adults. Associated with end-organ dysfunction such as syncope, incontinence, hypotonia.

101
Q

Hypotension in Adults

A

Systolic BP less than 90 after exposure to a known allergen.

102
Q

Hypotension in anaphylaxis

A

Common in severe reactions, indicating a drop in blood pressure.

103
Q

Hypoxemia

A

An abnormally low concentration of oxygen in the blood.

104
Q

Hypoxia

A

A condition where the body or a region of the body is deprived of adequate oxygen supply.

105
Q

Idiopathic

A

Refers to cases of anaphylactic reaction where the causes cannot be identified.

106
Q

IgE antibodies

A

Immunoglobulin E antibodies that are produced in response to an allergen and are involved in allergic reactions.

107
Q

IgE-Mediated Anaphylactic Reaction

A

A type of reaction that involves IgE antibodies stimulating the release of chemical substances. AKA Classic Anaphylactic Reaction

108
Q

Immediate transport

A

The urgent transfer of a patient to a medical facility when signs of severe anaphylaxis are present.

109
Q

Immune Response

A

The process in which the immune system detects an antigen and produces antibodies.

110
Q

Immune System

A

The body’s defense mechanism to fight off invasion by foreign substances.

111
Q

Immunoglobulin E (IgE)

A

The type of antibody produced specific to anaphylaxis.

112
Q

Impending doom

A

A feeling expressed by patients that they are about to die or that something very serious is happening.

113
Q

Inclusion Criteria

A

Patients of all ages with suspected allergic reaction and/or anaphylaxis.

114
Q

Increased bronchiole airway resistance

A

Wheezing, rhonchi, cough, dyspnea, tightness in the center of the chest, tachypnea, respiratory distress, and cyanosis

115
Q

Increased capillary permeability

A

Allows more water to permeate out from capillaries.

116
Q

Indications for epinephrine administration

A

EMT has an order from medical direction, and one of the following three criteria is met.

117
Q

Infants and children dosage

A

The injector for infants and children weighing less than 30 kg delivers a lower dose of epinephrine.

118
Q

Ingestion

A

The route where the patient swallows the substance.

119
Q

Inhalation

A

The route where the patient breathes the substance into his lungs.

120
Q

Injection

A

The route where the substance is introduced directly into the body by bites, stings, needles, or infusions.

121
Q

Injection through clothing

A

If it is too difficult to remove clothing from the site of injection, the injection can be given directly through the clothing.

122
Q

Interstitial fluid

A

Fluid that surrounds cells in tissues and is involved in the transport of chemical mediators during anaphylaxis.

123
Q

Interventions for worsening condition

A

Consult with medical direction about injection of a second dose of epinephrine, provide emergency care for shock, be prepared to initiate positive pressure ventilation, and be prepared to initiate CPR and apply AED if the patient becomes pulseless.

124
Q

Intramuscular injection of epinephrine

A

A syringe and needle are used to draw up for the adult (0.3 mg or greater) and for the child (0.01 to 0.3 mg).

125
Q

Key Considerations for EMS

A

When anaphylaxis is suspected, EMS personnel should always consider epinephrine as first-line treatment.

126
Q

Laryngeal edema

A

Stridor, dyspnea, hoarseness, tightness in the throat, and excessive salivation

127
Q

Last Oral Intake

A

The time and type of food or drink consumed by the patient prior to the anaphylactic reaction.

128
Q

Latex

A

A common allergen found in examination gloves and medical devices.

129
Q

Life-threatening responses

A

Responses directly produced from the release of chemical mediators during anaphylaxis, including bronchoconstriction, increased capillary permeability, and vasodilation.

130
Q

Life-threatening second reaction

A

Can occur even if the first reaction was not severe.

131
Q

Localized Allergic Reaction

A

A localized allergic reaction (e.g., urticaria or angioedema that does not compromise the airway) may be treated with antihistamine therapy.

132
Q

Localized reaction

A

A reaction that is confined to a specific area of the body, often seen with insect bites or stings.

133
Q

Major responses to chemical mediators in anaphylaxis

A

Increase in capillary permeability, vasodilation, and bronchoconstriction and inflammation.

134
Q

Malaise

A

A general feeling of weakness or discomfort often reported by patients experiencing anaphylaxis.

135
Q

Mast cells

A

Cells located in connective tissue, concentrated around the heart, lungs, and vessels, that play a key role in allergic reactions.

136
Q

Medication form of epinephrine

A

Epinephrine is a liquid drug.

137
Q

Medication history

A

A record of all medications a patient has taken, important in assessing allergic reactions.

138
Q

Medications causing anaphylaxis

A

Includes antibiotics, local anesthetics, aspirin, and seizure medications.

139
Q

Mild allergic reaction

A

A reaction that does not exhibit signs of respiratory compromise or poor perfusion.

140
Q

Mucus production in allergic reactions

A

Increases in moderate-to-severe allergic reactions, potentially occluding smaller bronchioles.

141
Q

Nasal cannula

A

A device used to deliver supplemental oxygen in less severe cases of hypoxemia.

142
Q

Nature of Allergic Reactions

A

Allergic reactions and anaphylaxis are serious and potentially life-threatening medical emergencies. It is the body’s adverse reaction to a foreign protein (e.g., food, medicine, pollen, insect sting or any ingested, inhaled, or injected substance).

143
Q

Non-anaphylactic Allergic Reaction

A

Signs involving only one organ system (e.g., localized angioedema that does not compromise the airway, or not associated with vomiting, hives alone).

144
Q

Non-IgE-mediated reaction

A

A reaction similar to an anaphylactic reaction but does not require previous exposure to the antigen.

145
Q

Nonrebreather mask

A

A mask used to deliver high concentrations of oxygen, typically used when a patient exhibits signs of severe hypoxemia.

146
Q

OPQRST

A

A line of questioning used to assess the history of the present illness.

147
Q

Oral or nasal airway

A

An airway adjunct that can prevent the tongue from occluding the airway in unresponsive patients.

148
Q

Oral pruritus

A

Itching in the mouth, often the first symptom observed in food-induced anaphylaxis.

149
Q

Patient assessment clues

A

Medications found at the scene or the patient’s recent activities can indicate a possible anaphylactic reaction.

150
Q

Patient Care Goals

A

1 Provide timely therapy for potentially life-threatening reactions to known or suspected allergens to prevent cardiorespiratory collapse and shock. 2 Provide symptomatic relief for symptoms due to known or suspected allergens.

151
Q

Patient sensitization

A

The state of being sensitized to a substance after the formation of IgE antibodies, making the patient prone to anaphylactic reactions.

152
Q

Patient’s response to epinephrine

A

Rapid; within seconds, the patient will begin to feel relief.

153
Q

Pediatric Hypotension Chart

A

A chart that outlines systolic BP limits for infants and children.

154
Q

Pediatric Vital Signs

A

Refer to vital signs for pediatrics chart for specific metrics.

155
Q

Penicillin

A

The most common medication that causes anaphylactic reactions.

156
Q

Physical activities triggering anaphylaxis

A

Activities such as jogging or dancing that can provoke anaphylactic reactions when combined with certain foods.

157
Q

Physical Exam

A

Focus the physical exam on the patient’s complaints involving the airway, breathing, and circulation. Major concerns are a compromised airway, inadequate breathing, and shock (hypoperfusion). Inspection of the face and neck typically reveals a swollen appearance and hives.

158
Q

Pollen

A

A substance from plants that can trigger allergic reactions, particularly from ragweed and grasses.

159
Q

Pop-off relief valve

A

A feature on a bag-valve-mask device that may need to be deactivated to deliver sufficient tidal volume.

160
Q

Pop-off valve

A

A valve that may need to be deactivated to deliver adequate ventilations with a bag-valve-mask.

161
Q

Positive pressure ventilation

A

A method to force air past a swollen upper airway.

162
Q

Positive pressure ventilation

A

A method to force air past swollen tissues when airway adjuncts are ineffective.

163
Q

Preferred injection site for epinephrine

A

The anterolateral portion of the thigh midway between the hip and knee is preferred for intramuscular injection.

164
Q

Primary assessment

A

A critical evaluation of a patient to identify life-threatening conditions, especially in anaphylactic cases.

165
Q

Progressive Symptoms

A

Signs and symptoms that may indicate whether the reaction is worsening or improving.

166
Q

Pruritus

A

Itching that can be localized or diffuse, often associated with allergic reactions.

167
Q

Rare anaphylactic triggers

A

Substances like glue, hair dye, and transfused blood that can cause anaphylactic reactions in some individuals.

168
Q

Reaction Time

A

The time it takes for signs and symptoms to appear after exposure to an antigen, which can vary from seconds to hours.

169
Q

Readministration of epinephrine

A

Common and necessary if the second reaction is severe.

170
Q

Reassessment

A

Critical in managing allergic reactions; involves monitoring for worsening conditions and effectiveness of interventions.

171
Q

Reassessment after epinephrine administration

A

Following the administration of epinephrine, it is necessary to reassess the patient, including evaluation of airway, breathing, and circulatory status.

172
Q

Reduced SBP

A

Occurs after exposure to a known allergen within minutes to several hours.

173
Q

Repeat dosage

A

The dose can be repeated in 5 to 15 minutes if the condition does not improve.

174
Q

Respiratory compromise

A

A condition where breathing is impaired, often seen in anaphylactic reactions.

175
Q

Respiratory distress

A

A condition where a patient has difficulty breathing, often seen in anaphylaxis.

176
Q

Respiratory rate in anaphylaxis

A

Can be fast and labored early in the reaction, then slow and shallow as the patient tires.

177
Q

Respiratory System

A

Patient complaints of a ‘lump in the throat’, tightness in the chest, high-pitched cough, tachypnea, labored breathing, noisy breathing (wheezing, stridor, or crowing), impaired ability to talk or hoarseness, excessive amounts of coughed-up mucus, partially or completely occluded airway, difficulty in breathing

178
Q

Retractions

A

A sign noted upon inspection indicating poor rise and fall of the chest.

179
Q

Rhinitis

A

A condition characterized by a stuffy, runny, or itchy nose, often an early sign of respiratory involvement in anaphylaxis.

180
Q

Route of Exposure

A

The method by which the patient was exposed to the antigen, such as injection, ingestion, inhalation, or contact.

181
Q

Scene size-up

A

An assessment of the environment to ensure safety before approaching a patient with anaphylaxis.

182
Q

Secondary assessment in anaphylaxis

A

Assess circulation and perform secondary assessment after administering epinephrine.

183
Q

Self-administration of epinephrine

A

Epinephrine comes packaged in a disposable delivery system for self-administration.

184
Q

Sensitization

A

The process where the body produces antibodies against a specific antigen upon first exposure.

185
Q

Sensitization

A

The process of developing hypersensitivity on first exposure to an antigen, resulting in an IgE-mediated anaphylactic reaction.

186
Q

Severe allergic reaction

A

Includes anaphylactic reaction and anaphylactoid reaction because the signs and symptoms and treatment are the same.

187
Q

Severe Anaphylactic Reaction

A

A reaction suspected if signs and symptoms occur within minutes after exposure to the antigen.

188
Q

Severe anaphylactic reaction indicators

A

Airway and respiratory compromise; Shock (hypoperfusion); Gastrointestinal (GI) signs and symptoms.

189
Q

Severe respiratory distress

A

A condition where air movement is minimal through the bronchioles, possibly leading to absent wheezing or breath sounds.

190
Q

Shock (Hypoperfusion)

A

A condition resulting from decreased blood pressure during anaphylactic reactions.

191
Q

Shock (hypoperfusion)

A

Indicated by checking pulses, skin temperature, color, and condition.

192
Q

Side effects of epinephrine

A

Possible side effects include increased heart rate, pale skin (pallor), dizziness, chest pain, headache, nausea and vomiting, excitability and anxiousness.

193
Q

Signs and Symptoms

A

Clinical indicators that may suggest an anaphylactic reaction, which can involve multiple body systems.

194
Q

Signs of anaphylactic reaction

A

Symptoms may include difficulty breathing, itching, swelling, and a sense of impending doom.

195
Q

Signs of Anaphylaxis

A

Two or more of the following occurring rapidly after exposure to a likely allergen: 1 Skin and/or mucosal involvement (urticaria, itchy, swollen tongue/lips). 2 Respiratory compromise (dyspnea, wheezing, stridor, hypoxemia). 3 Persistent gastrointestinal symptoms (vomiting, abdominal pain, diarrhea). 4 Hypotension or associated symptoms (syncope, hypotonia, chest tightness, incontinence).

196
Q

Signs of deterioration

A

Includes wheezing, stridor, increased hoarseness, inadequate breathing, decreasing mental status, decreasing blood pressure, increasing heart rate, and weak or absent radial pulses.

197
Q

Signs of respiratory involvement

A

Includes dyspnea, wheezing, cough, stridor, and hypoxemia.

198
Q

Signs of respiratory involvement

A

Symptoms indicating respiratory distress, such as dyspnea, wheezing, cough, and stridor.

199
Q

Signs of systemic reaction

A

Include hypotension, respiratory distress, and upper airway edema.

200
Q

Signs of worsening anaphylactic reaction

A

Decreasing mental status, decreasing blood pressure, increased difficulty in breathing, and signs of respiratory distress.

201
Q

Skin (early symptom)

A

Warm, tingling feeling in the face, mouth, chest, feet, and hands

202
Q

Skin (hallmark sign)

A

Hives (urticaria)

203
Q

Skin (hallmark symptom)

A

Intense itching (pruritus), especially of hands and feet

204
Q

Skin appearance in severe anaphylaxis

A

Usually red, dry, and warm to the touch, differing from other types of shock.

205
Q

Skin assessment

A

An evaluation of the skin for signs such as hives, redness, or swelling during an allergic reaction.

206
Q

Skin Signs

A

Physical indicators on the skin that may or may not be present in cases of anaphylaxis.

207
Q

Skin: Edema

A

Swelling especially around eyes, mouth, and extremities

208
Q

Skin: Urticaria (Hives)

A

Pruritus (itching), tingling and warmth sensation, flushing, and redness

209
Q

Steroids in allergic reactions

A

There is no proven benefit to using steroids in the management of allergic reactions and/or anaphylaxis.

210
Q

Stinging ants

A

Includes fire ants, which are part of the Hymenoptera family.

211
Q

Stridorous sounds

A

Sounds produced during respiration due to swelling of the larynx, indicating partial airway occlusion.

212
Q

Suction secretions

A

The process of clearing the mouth of secretions when necessary, especially in severe anaphylactic reactions.

213
Q

Sudden onset

A

Occurs within minutes to several hours with involvement of skin, mucosal tissue, or both.

214
Q

Supplemental oxygen

A

Oxygen provided to a patient when there are signs of respiratory distress, poor perfusion, hypoxemia, or hypoxia.

215
Q

Supplemental oxygen

A

Oxygen that must be delivered through the ventilation delivery device if the patient is being ventilated via bag-valve-mask.

216
Q

Swelling of the larynx

A

Indicated by swollen face, neck, tongue, and lips, which can cause stridorous sounds during respiration.

217
Q

Systemic anaphylactic reaction

A

A widespread allergic reaction that affects the entire body, often resulting from the release of chemical mediators.

218
Q

Systemic anaphylactic reaction

A

A severe allergic reaction that may present with hypotension, respiratory distress, gastrointestinal symptoms, or upper airway edema.

219
Q

Systemic Response

A

An immune response producing effects throughout the body.

220
Q

Systolic blood pressure (SBP)

A

The pressure in the arteries during the contraction of the heart, with specific thresholds for adults and children in anaphylaxis.

221
Q

Tachycardia

A

An increased heart rate that can occur during anaphylactic reactions.

222
Q

Topical Anti-Inflammatory Cream

A

A cream, such as hydrocortisone, used to treat signs and symptoms of mild allergic reactions.

223
Q

Trade name of epinephrine

A

Adrenalin.

224
Q

Trade names of epinephrine auto-injectors

A

EpiPen, EpiPen Jr., and Twinject (adult and child sizes).

225
Q

Transport Protocol

A

Transport as soon as possible, and perform ongoing assessment as indicated. Cardiac monitoring is not required, but should be considered for those with known heart problems or who received multiple doses of epinephrine.

226
Q

Two or more symptoms

A

Occurs rapidly after exposure to a likely allergen or trigger, including skin involvement, respiratory compromise, hypotension, and gastrointestinal symptoms.

227
Q

Urticaria

A

Hives or welts on the skin, which can be localized or generalized in allergic reactions.

228
Q

Vasodilation

A

The dilation of blood vessels that occurs during anaphylactic reactions.

229
Q

Vasodilation

A

The widening of blood vessels, which can lead to a drop in blood pressure during an anaphylactic reaction.

230
Q

Vasodilation

A

The increase of the diameter of a vessel.

231
Q

Vasodilation

A

The widening of blood vessels, which can occur during an anaphylactic reaction.

232
Q

Vasodilation

A

A process that can cause loss of up to 50% of circulating blood volume, leading to decreased preload and cardiovascular collapse.

233
Q

Vasovagal event

A

A sudden drop in heart rate and blood pressure leading to fainting, which can occur during allergic reactions.

234
Q

Ventilation equipment

A

Equipment that should be ready to assist ventilation if necessary, especially in allergic reactions.

235
Q

Vespids

A

Includes yellow jackets, hornets, and wasps, which are part of the Hymenoptera family.

236
Q

Vital signs assessment

A

Involves monitoring breathing, pulse, and blood pressure during anaphylactic reactions.

237
Q

Warm, flushed skin

A

Skin appearance that can indicate an allergic reaction, sometimes appearing paler than usual.

238
Q

Weather conditions triggering anaphylaxis

A

Factors such as heat, cold, and humidity that can provoke an allergic reaction.

239
Q

Weight criteria for epinephrine auto-injectors

A

The dose of epinephrine is for patients weighing 30 kg or greater.

240
Q

Wheezing

A

A sound caused by constriction and inflammation of the bronchioles, leading to increased airway resistance.

241
Q

Wheezing

A

A diffuse sound heard on auscultation of breath sounds, indicating bronchoconstriction.