Immunologic Emergencies Flashcards
Allergy & Anaphylaxis
How can a allergic reaction effect the lungs?
Bronchospasm & Vasoconstriction
How can a allergic reaction effect the heart?
decreased output
decreased coronary flow
Define
Allergic reaction
An allergic reaction is the body’s exaggerated immune response to a foreign substance (allergen) that is usually harmless to most people.
reactions can be local or systemic
Define
Anaphylaxis
systemic allergic reaction characterized by rapid onset and involving multiple body systems
How can a allergic reaction effect the blood vessels?
Vasodilation
leakiness
How can a allergic reaction effect the skin?
Pruritus
Urticaria
Edema
Define
Pruritus
itching
Define
Urticaria
Hives
small areas of generalized itching or burning that appear as multiple small, raised areas on the skin
Define
Angioedema
areas of localized
swelling
Name some common allergies
Food
Medication
Plants
Chemicals
Insect bites and stings
Define
Envenomation
When an insect bites or stings, the act of injecting venom is called Envenomation
honeybee, wasp, ant, yellow jacket, or hornet
How do you manage anaphylaxis?
Epinephrine
MDI
Oxygen
Define
Wheal
a raised, swollen, welldefined
area on the skin
more than two-thirds of patients who die of anaphylaxis do so within the
first ___
30 minutes
Define
Stridor
High-pitched breathing sound.
Indicates upper airway narrowing and is a critical finding
Define
Allergic Conjunctivitis
Inflammation of the conjunctiva.
Characterized by red, itchy, watery eyes, often due to airborne allergens.
Anaphylaxis Triggers
Food Allergens
Peanuts, tree nuts, milk, eggs, soy, wheat, fish, shellfish
Anaphylaxis Triggers
Insect Stings
Bees, wasps, yellow jackets, hornets
Anaphylaxis Triggers
Medications
Penicillin, NSAIDs, contrast dyes, latex
Anaphylaxis Triggers
Airborne Allergens
Pollen, mold spores, dust mites, animal dander
These commonly cause seasonal allergies and respiratory symptoms like sneezing and runny nose.
Anaphylaxis Triggers
Contact Allergens
Poison ivy, latex, nickel, certain chemicals
Direct skin contact with these substances can lead to localized rashes and itching
What is the treatment for anaphylaxis?
Epinephrine 0.3mg IM auto-injector
Define
Histamines
Chemical substances released by the immune system in allergic reactions that are responsible for many of the symptoms of anaphylaxis, such as vasodilation
Define
Leukotrienes
Chemical substances that contribute to anaphylaxis; released by the immune system in allergic reactions
Signs & Symptoms
Black Widow bite
Local symptoms at bite site
- immediate sharp pain
- rapidly developing dull, aching pain
- localized swelling
- redness
- 2 small fang marks
Signs & Symptoms
Black Widow bite
Systemic Symptoms
- Severe muscle cramps and spasms
- rigid abdomen
- chest pain
- difficulty breathing
- sweating profusely
- nausea and vomiting
Signs & Symptoms
Brown Recluse Spider
Initial Bite
- Often painless
- small red mark
Signs & Symptoms
Brown Recluse Spider
Progression of symptoms
Usually within 2-8 hours
- Localized pain & itching
- Blister surrounded by a white ring which is the surrounded by a red area
- Necrotic lesion
What is a Hymenoptera sting?
sting from bees, wasps, yellow jackets, hornets and ants
Primary venomous snake in Southern California
Rattlesnakes
Sign and symptom
Immediate, severe burning pain at bite site
This is a hallmark initial symptom of rattlesnake envenomation
Signs & Symptoms
Rattlesnake bite
- Rapid, progressive swelling around the bite
- Numbness or tingling around the mouth or scalp
- Metallic or rubbery taste in the mouth.
- Muscle twitching or weakness.
- Nausea and vomiting
What type of scorpion sting is most common in the Los Angeles area?
California scorpion
What are the typical local symptoms of a California scorpion sting?
Immediate burning pain, numbness or tingling around the sting, mild swelling, and redness.
Are severe systemic symptoms common with a California scorpion sting in healthy adults?
No, severe systemic symptoms are usually rare with California scorpion stings in healthy adults.
Which age groups are generally more susceptible to severe reactions from scorpion stings?
Young children and the elderly tend to be at higher risk
What are some common local reactions at the site of a tick bite?
A small red bump or area of redness, similar to a mosquito bite, and often some itching.
What is a characteristic early sign of Lyme disease that can appear after a tick bite?
A rash that looks like a bull’s-eye, known as erythema migrans, which can appear days to weeks after the bite.
Besides the rash, what are some other early symptoms that might suggest a tick-borne illness like Lyme disease?
Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes
What are some other tick-borne illnesses that are present in California, besides Lyme disease?
Anaplasmosis and Ehrlichiosis are also found in California and can cause symptoms like fever, headache, and muscle aches.
When should an EMT-B be concerned about a tick bite and consider further medical evaluation?
If the patient reports symptoms such as fever, rash, headache, fatigue, or muscle/joint pain, especially if they recall a recent tick bite.
How long do ticks need to transmit Lyme disease
24-48hrs
What are some respiratory signs and symptoms that might indicate anaphylaxis from a Hymenoptera sting?
Difficulty breathing, wheezing (a whistling sound when breathing), throat tightness or swelling, and hoarseness.
What are some cardiovascular signs and symptoms that might indicate anaphylaxis from a Hymenoptera sting?
Dizziness or lightheadedness, fainting or loss of consciousness, a rapid or weak pulse, and a drop in blood pressure.
What are some skin-related signs and symptoms that might indicate anaphylaxis from a Hymenoptera sting?
Generalized hives (raised, itchy welts all over the body), itching all over, flushing (reddening of the skin), and swelling of the lips, tongue, or face.
What is a common immediate sensation after being stung by fire ants?
An intense burning pain at each sting site
What is a characteristic skin reaction that develops at the site of fire ant stings?
The formation of itchy, fluid-filled bumps or pustules, often appearing a day or two after the stings.
How do fire ant stings often appear on the skin?
They typically appear as a line or cluster of small, raised bumps or pustules, reflecting the multiple stings from a single ant
What is the first step in treating stings/venomous bites?
Assess airway and initiate basic and/or advanced airway maneuvers as needed
What should you prioritize in the treatment of stings/venomous bites?
Treatment of systemic symptoms.
What general advice should you give to a patient who has been stung or bitten?
Keep patient calm and limit activity. Position affected extremity at or below the level of the heart.
How should you treat a snake bite?
Splint the affected area and elevate the extremity to the level of the heart.
How should you treat insect (bee, wasp, ant), spider, and scorpion stings?
Remove stinger if visualized and apply a cold pack.
How should you treat marine envenomation (e.g., jellyfish, stingrays, and scorpionfish)?
Remove barb when applicable and soak the area in hot water if available.
How should you remove a bee stinger?
By scraping the patient’s skin with the edge of a flat surface (credit card or similar). Do not attempt to pull it out with fingernails or tweezers.
What is the primary treatment for chemical burns to the eye?
Thoroughly flush out the eye with water.
What is a primary concern in the prehospital treatment of thermal burns regarding the patient’s body temperature?
Hypothermia, as burn patients cannot regulate their temperature effectively.
What is generally NOT recommended for cooling a burn injury?
Submerging the burned area in water for extended periods, as this can reduce the tensile strength of the skin and increase the risk of tearing
What is the initial focus of prehospital treatment for thermal burns?
Cooling of the burn injury.
What type of dressings is recommended for covering burns during transport?
Dry, sterile dressings.
the black widow’s venom can damage _____
nerve tissues
it is a neurotoxin
Where can you find a black widow spider?
They prefer dry, dim places around buildings, in woodpiles, and among debris
Where can you find a brown recluse spider?
in dark areas—in corners of old, unused buildings, under rocks, and in woodpiles
In cooler areas, it moves indoors to closets, drawers, cellars, and clothing.
Brown Recluse spiders venom is a _____
cytotoxic
causes severe local tissue damage
Name 3 Pit Vipers
Rattlesnakes, copperheads, and cottonmouths
They take their name from the small pits located just behind each nostril and in front of each eye
How long do Pit Vipers bite symptoms last?
up to 36 hours
onset is 5-10 minutes
