Chapter 21 Flashcards
1
Q
Abdominal cramping
A
A common gastrointestinal symptom associated with food-induced anaphylaxis.
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.
3
Q
Activation of auto-injector
A
Activated by pressing it against the patient’s thigh, releasing a spring-activated plunger.
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.
5
Q
Acute respiratory compromise
A
A reaction with normal bronchiole and normal airway resulting in an occluded upper airway and labored respirations.
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.
7
Q
Adult dose of epinephrine
A
The dosage for adults is typically 0.3 mg or greater.
8
Q
Advanced life support (ALS)
A
May be needed for advanced airway control and further medication administration in severe cases.
9
Q
Agitation
A
A state of anxiety or restlessness that may be observed in patients experiencing anaphylaxis.
10
Q
Airway compromise
A
Swelling of the tissues lining the larynx that can obstruct airflow.
11
Q
Airway obstruction signs
A
Indicators such as stridor, hoarseness, or crowing sounds that suggest significant swelling of the airway.
12
Q
Allergens
A
A specific type of antigen that causes an abnormal response by the immune system.
13
Q
Allergic Reaction
A
A misdirected and excessive response by the immune system to an allergen.
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.
15
Q
Alpha properties of epinephrine
A
Causes the vessels to constrict and regulates the amount of vasoconstriction.
16
Q
Altered mental status (AMS)
A
Changes in mental function that may occur during severe allergic reactions.
17
Q
Anaphylactic reaction
A
A severe allergic reaction that can cause weak and rapid pulse, edema, and respiratory distress.
18
Q
Anaphylactic Reaction Criteria for Epinephrine Administration
A
Criteria that require aggressive emergency care and administration of epinephrine when specific conditions are met.
19
Q
Anaphylactic Shock
A
A life-threatening response characterized by cardiovascular collapse and hypotension.
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
21
Q
Anaphylactoid reaction
A
A non-IgE mediated reaction that can occur the first time an antigen is introduced into the body.
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.
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.
24
Q
Antibodies
A
Proteins that search for the antigen, combine with it, and help to destroy it.
25
Antigen
A foreign substance that induces an immune response, including the production of IgE antibodies.
26
Antihistamine
A medication, such as diphenhydramine (Benadryl), used to treat mild allergic reactions.
27
Assessment for Anaphylaxis
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.
28
Asthma
A chronic respiratory condition that increases the risk of severe allergic reactions.
29
Auvi-Q
An auto-injector for epinephrine that is about the size of a credit card and has audio instructions for the injection process.
30
Bag-valve-mask device
A device used to deliver positive pressure ventilation, which may be harder to compress in obstructed airways.
31
Basophils
White blood cells that circulate in the blood and are involved in the immune response, particularly in allergic reactions.
32
Bees
Includes honeybees and bumblebees, which are part of the Hymenoptera family.
33
Beta properties of epinephrine
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.
34
Beta-Blocker
A medication that may limit the response to epinephrine in patients experiencing anaphylaxis.
35
Biphasic Anaphylactic Reaction
Occurs when initial symptoms resolve and a second reaction occurs approximately 1-72 hours later.
36
Bites and stings
Insect bites or stings that can lead to anaphylaxis, particularly from yellow jackets or wasps.
37
Breathing assessment
If breathing is inadequate, administer PPV with oxygen.
38
Bronchial Constriction
Narrowing of the air passages in the lungs, which can be a symptom of anaphylaxis.
39
Bronchoconstriction
A life-threatening response in anaphylaxis characterized by the tightening of the muscles around the airways, putting pressure on the alveoli.
40
Capillaries
Small blood vessels that facilitate the exchange of substances between the blood and tissues, including the transport of chemical mediators.
41
Capillary permeability
The ability of capillaries to allow substances to pass through their walls, which increases during anaphylaxis leading to fluid leakage. Can lead to shock.
42
Cardiovascular Collapse
Cardiovascular collapse may occur abruptly, without the prior development of skin or respiratory symptoms.
43
Cardiovascular collapse and poor perfusion
Tachycardia, hypotension, syncope, light-headedness, general weakness, syncope, and chest pain
44
Cardiovascular System
Tachycardia (increased heart rate), hypotension (decreased blood pressure), irregular pulse, absent radial pulse (severe shock)
45
Central Nervous System
Another body system that may exhibit signs and symptoms during an anaphylactic reaction. Increased anxiety, light-headedness, unresponsiveness, disorientation, restlessness, seizures, headache
46
Chemical mediators
Substances released from mast cells and basophils that cause a cascade of events leading to anaphylaxis.
47
Chemical Substances
Substances released during an anaphylactic reaction that affect the entire body.
48
Chest Pain
A symptom that may occur in patients experiencing anaphylaxis, sometimes alongside dyspnea.
49
Chronic obstructive pulmonary disease (COPD)
A group of lung diseases that block airflow and make it difficult to breathe, increasing the risk of severe allergic reactions.
50
Circulatory compromise
A state where blood circulation is inadequate, which can occur during severe allergic reactions.
51
Common allergens causing anaphylaxis
Foods like peanuts, nuts, milk, eggs, shellfish, and certain medications.
52
Common causes of anaphylactic reaction
Medications, idiopathic causes, and various allergens including food and insect stings.
53
Contact (absorption)
The route where the antigen is absorbed through the skin.
54
Contraindications for epinephrine
There are no contraindications for the administration of epinephrine in a life-threatening anaphylactic reaction.
55
Criteria 1 for epinephrine administration
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).
56
Criteria 2 for epinephrine administration
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).
57
Criteria 3 for epinephrine administration
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.
58
Cutaneous manifestations
Signs such as urticaria or mucocutaneous swelling that are commonly associated with anaphylaxis.
59
Cyanotic skin
Skin that appears blue due to inadequate breathing.
60
Desensitization
A medical process that may reduce the likelihood of an anaphylactic reaction upon subsequent exposures to the same antigen.
61
Diminished breath sounds
A sign of inadequate respiration, indicating the need for immediate positive pressure ventilation.
62
Disposal of auto-injector
Dispose of the device in a biohazard puncture-resistant container.
63
Distinguishing reactions
EMTs must differentiate between systemic anaphylactic reactions and local allergic reactions.
64
Epinephrine Dosage for adults
0.3 milligram for an adult.
65
Dosage for children
0.15 milligram for a child.
66
Duration of epinephrine's effectiveness
Short, only approximately a few minutes.
67
Dyspnea
Shortness of breath, which can occur before other signs and symptoms in anaphylaxis.
68
Early transport
Initiate transport of the patient without unnecessary delay; continued assessment can be done en route.
69
Edema
Swelling caused by excess fluid trapped in the body's tissues.
70
Emergency care algorithm
A systematic approach to managing anaphylactic reactions, including assessing mental status and administering oxygen.
71
Emergency care for severe anaphylaxis
Requires immediate and aggressive intervention by EMTs, including maintaining a patent airway.
72
EMS unit protocol for epinephrine
If no epinephrine is prescribed or carried on the EMS unit, transport and reassess.
73
End organ dysfunction
Symptoms indicating that organs are not receiving enough blood flow, such as syncope or incontinence.
74
Endotracheal intubation
The placement of a tube in the trachea to facilitate breathing, usually performed by an advanced life support (ALS) team.
75
Epinephrine
A medication administered in severe systemic anaphylactic reactions, especially when hypotension or respiratory distress is present.
76
Epinephrine auto-injector
A device typically used to administer epinephrine, though some systems may use an ampule and syringe.
77
Epinephrine injection
Should be reassessed for effectiveness in reversing life-threatening conditions.
78
Epinephrine's antihistamine effect
Reduces the effects of histamine.
79
Epinephrine's effect on bronchioles
Causes bronchodilation, reversing bronchoconstriction.
80
Epinephrine's effect on capillaries
Causes vasoconstriction and tightens the capillaries, reversing the vasodilation and increased capillary permeability experienced by the anaphylactic patient.
81
EpiPen
A disposable delivery system for self-administration of epinephrine.
82
EpiPen auto-injector expense
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.
83
Exercise-induced anaphylaxis
A condition where physical activity can exacerbate anaphylactic reactions, especially after eating certain foods.
84
Eye: Conjunctivitis
Red and itchy eyes, increased tears, swelling to eyes
85
Fire ants
Their bite is similar to that of a bee or hornet and can cause severe allergic reactions.
86
Flushed or red skin
Swelling to the face, lips, neck, hands, feet, and tongue
87
Food-induced anaphylaxis
Anaphylaxis triggered by exposure to food allergens, which may not always present with cutaneous symptoms.
88
Gastrointestinal symptoms
Symptoms such as nausea, vomiting, and diarrhea that can occur during food-induced anaphylaxis.
89
Generalized Signs and Symptoms
Itchy, watery eyes, runny or stuffy nose, sense of impending doom, complaints of 'not feeling well', general weakness or discomfort
90
Genitourinary System
A body system that can also be involved in the signs and symptoms of anaphylaxis. Urinary incontinence, vaginal bleeding, and pelvic pain
91
Granules
Small particles within mast cells and basophils that contain chemical mediators and are released during an allergic reaction.
92
High index of suspicion
The need for thorough assessment in potential allergic reaction patients, considering various factors.
93
Histamine
The primary chemical mediator released from mast cells and basophils, causing bronchoconstriction, vasodilation, and increased capillary permeability.
94
History Taking
The process of obtaining information from the patient or bystanders to assess the situation, especially if the patient is unresponsive.
95
Hives
Raised red blotches on the skin, usually accompanied by severe itching, and are a hallmark sign of an allergic reaction. Most common complaint.
96
Hymenoptera
The family of insects that account for the majority of severe allergic reactions and anaphylaxis related to insect bites.
97
Hymenoptera venom
Venom from insects such as bees and fire ants that can cause severe allergic reactions.
98
Hypersensitivity
A condition that develops during the first exposure to an antigen, leading to an anaphylactic reaction upon subsequent exposures.
99
Hypoperfusion
A state of inadequate blood flow to the organs, which can occur during anaphylactic shock.
100
Hypotension
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
Hypotension in Adults
Systolic BP less than 90 after exposure to a known allergen.
102
Hypotension in anaphylaxis
Common in severe reactions, indicating a drop in blood pressure.
103
Hypoxemia
An abnormally low concentration of oxygen in the blood.
104
Hypoxia
A condition where the body or a region of the body is deprived of adequate oxygen supply.
105
Idiopathic
Refers to cases of anaphylactic reaction where the causes cannot be identified.
106
IgE antibodies
Immunoglobulin E antibodies that are produced in response to an allergen and are involved in allergic reactions.
107
IgE-Mediated Anaphylactic Reaction
A type of reaction that involves IgE antibodies stimulating the release of chemical substances. AKA Classic Anaphylactic Reaction
108
Immediate transport
The urgent transfer of a patient to a medical facility when signs of severe anaphylaxis are present.
109
Immune Response
The process in which the immune system detects an antigen and produces antibodies.
110
Immune System
The body's defense mechanism to fight off invasion by foreign substances.
111
Immunoglobulin E (IgE)
The type of antibody produced specific to anaphylaxis.
112
Impending doom
A feeling expressed by patients that they are about to die or that something very serious is happening.
113
Inclusion Criteria
Patients of all ages with suspected allergic reaction and/or anaphylaxis.
114
Increased bronchiole airway resistance
Wheezing, rhonchi, cough, dyspnea, tightness in the center of the chest, tachypnea, respiratory distress, and cyanosis
115
Increased capillary permeability
Allows more water to permeate out from capillaries.
116
Indications for epinephrine administration
EMT has an order from medical direction, and one of the following three criteria is met.
117
Infants and children dosage
The injector for infants and children weighing less than 30 kg delivers a lower dose of epinephrine.
118
Ingestion
The route where the patient swallows the substance.
119
Inhalation
The route where the patient breathes the substance into his lungs.
120
Injection
The route where the substance is introduced directly into the body by bites, stings, needles, or infusions.
121
Injection through clothing
If it is too difficult to remove clothing from the site of injection, the injection can be given directly through the clothing.
122
Interstitial fluid
Fluid that surrounds cells in tissues and is involved in the transport of chemical mediators during anaphylaxis.
123
Interventions for worsening condition
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
Intramuscular injection of epinephrine
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
Key Considerations for EMS
When anaphylaxis is suspected, EMS personnel should always consider epinephrine as first-line treatment.
126
Laryngeal edema
Stridor, dyspnea, hoarseness, tightness in the throat, and excessive salivation
127
Last Oral Intake
The time and type of food or drink consumed by the patient prior to the anaphylactic reaction.
128
Latex
A common allergen found in examination gloves and medical devices.
129
Life-threatening responses
Responses directly produced from the release of chemical mediators during anaphylaxis, including bronchoconstriction, increased capillary permeability, and vasodilation.
130
Life-threatening second reaction
Can occur even if the first reaction was not severe.
131
Localized Allergic Reaction
A localized allergic reaction (e.g., urticaria or angioedema that does not compromise the airway) may be treated with antihistamine therapy.
132
Localized reaction
A reaction that is confined to a specific area of the body, often seen with insect bites or stings.
133
Major responses to chemical mediators in anaphylaxis
Increase in capillary permeability, vasodilation, and bronchoconstriction and inflammation.
134
Malaise
A general feeling of weakness or discomfort often reported by patients experiencing anaphylaxis.
135
Mast cells
Cells located in connective tissue, concentrated around the heart, lungs, and vessels, that play a key role in allergic reactions.
136
Medication form of epinephrine
Epinephrine is a liquid drug.
137
Medication history
A record of all medications a patient has taken, important in assessing allergic reactions.
138
Medications causing anaphylaxis
Includes antibiotics, local anesthetics, aspirin, and seizure medications.
139
Mild allergic reaction
A reaction that does not exhibit signs of respiratory compromise or poor perfusion.
140
Mucus production in allergic reactions
Increases in moderate-to-severe allergic reactions, potentially occluding smaller bronchioles.
141
Nasal cannula
A device used to deliver supplemental oxygen in less severe cases of hypoxemia.
142
Nature of Allergic Reactions
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
Non-anaphylactic Allergic Reaction
Signs involving only one organ system (e.g., localized angioedema that does not compromise the airway, or not associated with vomiting, hives alone).
144
Non-IgE-mediated reaction
A reaction similar to an anaphylactic reaction but does not require previous exposure to the antigen.
145
Nonrebreather mask
A mask used to deliver high concentrations of oxygen, typically used when a patient exhibits signs of severe hypoxemia.
146
OPQRST
A line of questioning used to assess the history of the present illness.
147
Oral or nasal airway
An airway adjunct that can prevent the tongue from occluding the airway in unresponsive patients.
148
Oral pruritus
Itching in the mouth, often the first symptom observed in food-induced anaphylaxis.
149
Patient assessment clues
Medications found at the scene or the patient's recent activities can indicate a possible anaphylactic reaction.
150
Patient Care Goals
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
Patient sensitization
The state of being sensitized to a substance after the formation of IgE antibodies, making the patient prone to anaphylactic reactions.
152
Patient's response to epinephrine
Rapid; within seconds, the patient will begin to feel relief.
153
Pediatric Hypotension Chart
A chart that outlines systolic BP limits for infants and children.
154
Pediatric Vital Signs
Refer to vital signs for pediatrics chart for specific metrics.
155
Penicillin
The most common medication that causes anaphylactic reactions.
156
Physical activities triggering anaphylaxis
Activities such as jogging or dancing that can provoke anaphylactic reactions when combined with certain foods.
157
Physical Exam
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
Pollen
A substance from plants that can trigger allergic reactions, particularly from ragweed and grasses.
159
Pop-off relief valve
A feature on a bag-valve-mask device that may need to be deactivated to deliver sufficient tidal volume.
160
Pop-off valve
A valve that may need to be deactivated to deliver adequate ventilations with a bag-valve-mask.
161
Positive pressure ventilation
A method to force air past a swollen upper airway.
162
Positive pressure ventilation
A method to force air past swollen tissues when airway adjuncts are ineffective.
163
Preferred injection site for epinephrine
The anterolateral portion of the thigh midway between the hip and knee is preferred for intramuscular injection.
164
Primary assessment
A critical evaluation of a patient to identify life-threatening conditions, especially in anaphylactic cases.
165
Progressive Symptoms
Signs and symptoms that may indicate whether the reaction is worsening or improving.
166
Pruritus
Itching that can be localized or diffuse, often associated with allergic reactions.
167
Rare anaphylactic triggers
Substances like glue, hair dye, and transfused blood that can cause anaphylactic reactions in some individuals.
168
Reaction Time
The time it takes for signs and symptoms to appear after exposure to an antigen, which can vary from seconds to hours.
169
Readministration of epinephrine
Common and necessary if the second reaction is severe.
170
Reassessment
Critical in managing allergic reactions; involves monitoring for worsening conditions and effectiveness of interventions.
171
Reassessment after epinephrine administration
Following the administration of epinephrine, it is necessary to reassess the patient, including evaluation of airway, breathing, and circulatory status.
172
Reduced SBP
Occurs after exposure to a known allergen within minutes to several hours.
173
Repeat dosage
The dose can be repeated in 5 to 15 minutes if the condition does not improve.
174
Respiratory compromise
A condition where breathing is impaired, often seen in anaphylactic reactions.
175
Respiratory distress
A condition where a patient has difficulty breathing, often seen in anaphylaxis.
176
Respiratory rate in anaphylaxis
Can be fast and labored early in the reaction, then slow and shallow as the patient tires.
177
Respiratory System
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
Retractions
A sign noted upon inspection indicating poor rise and fall of the chest.
179
Rhinitis
A condition characterized by a stuffy, runny, or itchy nose, often an early sign of respiratory involvement in anaphylaxis.
180
Route of Exposure
The method by which the patient was exposed to the antigen, such as injection, ingestion, inhalation, or contact.
181
Scene size-up
An assessment of the environment to ensure safety before approaching a patient with anaphylaxis.
182
Secondary assessment in anaphylaxis
Assess circulation and perform secondary assessment after administering epinephrine.
183
Self-administration of epinephrine
Epinephrine comes packaged in a disposable delivery system for self-administration.
184
Sensitization
The process where the body produces antibodies against a specific antigen upon first exposure.
185
Sensitization
The process of developing hypersensitivity on first exposure to an antigen, resulting in an IgE-mediated anaphylactic reaction.
186
Severe allergic reaction
Includes anaphylactic reaction and anaphylactoid reaction because the signs and symptoms and treatment are the same.
187
Severe Anaphylactic Reaction
A reaction suspected if signs and symptoms occur within minutes after exposure to the antigen.
188
Severe anaphylactic reaction indicators
Airway and respiratory compromise; Shock (hypoperfusion); Gastrointestinal (GI) signs and symptoms.
189
Severe respiratory distress
A condition where air movement is minimal through the bronchioles, possibly leading to absent wheezing or breath sounds.
190
Shock (Hypoperfusion)
A condition resulting from decreased blood pressure during anaphylactic reactions.
191
Shock (hypoperfusion)
Indicated by checking pulses, skin temperature, color, and condition.
192
Side effects of epinephrine
Possible side effects include increased heart rate, pale skin (pallor), dizziness, chest pain, headache, nausea and vomiting, excitability and anxiousness.
193
Signs and Symptoms
Clinical indicators that may suggest an anaphylactic reaction, which can involve multiple body systems.
194
Signs of anaphylactic reaction
Symptoms may include difficulty breathing, itching, swelling, and a sense of impending doom.
195
Signs of Anaphylaxis
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
Signs of deterioration
Includes wheezing, stridor, increased hoarseness, inadequate breathing, decreasing mental status, decreasing blood pressure, increasing heart rate, and weak or absent radial pulses.
197
Signs of respiratory involvement
Includes dyspnea, wheezing, cough, stridor, and hypoxemia.
198
Signs of respiratory involvement
Symptoms indicating respiratory distress, such as dyspnea, wheezing, cough, and stridor.
199
Signs of systemic reaction
Include hypotension, respiratory distress, and upper airway edema.
200
Signs of worsening anaphylactic reaction
Decreasing mental status, decreasing blood pressure, increased difficulty in breathing, and signs of respiratory distress.
201
Skin (early symptom)
Warm, tingling feeling in the face, mouth, chest, feet, and hands
202
Skin (hallmark sign)
Hives (urticaria)
203
Skin (hallmark symptom)
Intense itching (pruritus), especially of hands and feet
204
Skin appearance in severe anaphylaxis
Usually red, dry, and warm to the touch, differing from other types of shock.
205
Skin assessment
An evaluation of the skin for signs such as hives, redness, or swelling during an allergic reaction.
206
Skin Signs
Physical indicators on the skin that may or may not be present in cases of anaphylaxis.
207
Skin: Edema
Swelling especially around eyes, mouth, and extremities
208
Skin: Urticaria (Hives)
Pruritus (itching), tingling and warmth sensation, flushing, and redness
209
Steroids in allergic reactions
There is no proven benefit to using steroids in the management of allergic reactions and/or anaphylaxis.
210
Stinging ants
Includes fire ants, which are part of the Hymenoptera family.
211
Stridorous sounds
Sounds produced during respiration due to swelling of the larynx, indicating partial airway occlusion.
212
Suction secretions
The process of clearing the mouth of secretions when necessary, especially in severe anaphylactic reactions.
213
Sudden onset
Occurs within minutes to several hours with involvement of skin, mucosal tissue, or both.
214
Supplemental oxygen
Oxygen provided to a patient when there are signs of respiratory distress, poor perfusion, hypoxemia, or hypoxia.
215
Supplemental oxygen
Oxygen that must be delivered through the ventilation delivery device if the patient is being ventilated via bag-valve-mask.
216
Swelling of the larynx
Indicated by swollen face, neck, tongue, and lips, which can cause stridorous sounds during respiration.
217
Systemic anaphylactic reaction
A widespread allergic reaction that affects the entire body, often resulting from the release of chemical mediators.
218
Systemic anaphylactic reaction
A severe allergic reaction that may present with hypotension, respiratory distress, gastrointestinal symptoms, or upper airway edema.
219
Systemic Response
An immune response producing effects throughout the body.
220
Systolic blood pressure (SBP)
The pressure in the arteries during the contraction of the heart, with specific thresholds for adults and children in anaphylaxis.
221
Tachycardia
An increased heart rate that can occur during anaphylactic reactions.
222
Topical Anti-Inflammatory Cream
A cream, such as hydrocortisone, used to treat signs and symptoms of mild allergic reactions.
223
Trade name of epinephrine
Adrenalin.
224
Trade names of epinephrine auto-injectors
EpiPen, EpiPen Jr., and Twinject (adult and child sizes).
225
Transport Protocol
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
Two or more symptoms
Occurs rapidly after exposure to a likely allergen or trigger, including skin involvement, respiratory compromise, hypotension, and gastrointestinal symptoms.
227
Urticaria
Hives or welts on the skin, which can be localized or generalized in allergic reactions.
228
Vasodilation
The dilation of blood vessels that occurs during anaphylactic reactions.
229
Vasodilation
The widening of blood vessels, which can lead to a drop in blood pressure during an anaphylactic reaction.
230
Vasodilation
The increase of the diameter of a vessel.
231
Vasodilation
The widening of blood vessels, which can occur during an anaphylactic reaction.
232
Vasodilation
A process that can cause loss of up to 50% of circulating blood volume, leading to decreased preload and cardiovascular collapse.
233
Vasovagal event
A sudden drop in heart rate and blood pressure leading to fainting, which can occur during allergic reactions.
234
Ventilation equipment
Equipment that should be ready to assist ventilation if necessary, especially in allergic reactions.
235
Vespids
Includes yellow jackets, hornets, and wasps, which are part of the Hymenoptera family.
236
Vital signs assessment
Involves monitoring breathing, pulse, and blood pressure during anaphylactic reactions.
237
Warm, flushed skin
Skin appearance that can indicate an allergic reaction, sometimes appearing paler than usual.
238
Weather conditions triggering anaphylaxis
Factors such as heat, cold, and humidity that can provoke an allergic reaction.
239
Weight criteria for epinephrine auto-injectors
The dose of epinephrine is for patients weighing 30 kg or greater.
240
Wheezing
A sound caused by constriction and inflammation of the bronchioles, leading to increased airway resistance.
241
Wheezing
A diffuse sound heard on auscultation of breath sounds, indicating bronchoconstriction.
