Immunology Flashcards
define anaphylaxis
a severe and life threatening generalised or systemic hypersensitivity reaction
3 common triggers on anaphylaxis
food (common in children)
drugs
venom
ABC changes in anaphylaxis
A: swelling of the throat/tongue causing stridor and hoarse voice
B: SOB and respiratory wheeze
C: hypotension and tachycardia
no ABC change = not anaphylaxis
skin changes in anaphylaxis
generalised pruritis
widespread erythematous/urticarial rash
management of anaphylaxis in adults over the age of 12
IM ADRENALINE
500 MICROGRAMS
0.5ML 1 IN 1000
adrenaline doses in under 12’s
under 6m: 100 mcg (0.1 ml 1 in 1000)
6m-6y: 150mcg (0.15ml 1 in 1000)
6y-12y: 300mcg (0.3ml 1 in 1000)
how often can adrenaline be repeated
every 5 mins
where is adrenaline injected into
anterolateral mid thigh
what is refractory anaphylaxis and how is it managed
respiratory/cardiac symptoms persist despite 2 doses of IM adrenaline
give IV fluids for shock and contact senior for IV adrenaline
management of anaphylaxis after stabilisation
non sedating oral antihistamine
referral to specialist allergy clinic
2 adrenaline autoinjectors and training
what can you measure up to 12 hours after the initial reaction to determine whether the reaction was true anaphylaxis
serum tryptase
when can you fast track discharge 2 hours after symptoms resolve
if good response to single IM adrenaline and compete symptom resolution
adrenaline autoinjector training
adequate home supervision
when can you discharge 6 hours after symptoms resolve
if 2 doses of IM adrenaline are needed or PMHx of a biphasic reaciton
when can you discharge 12 hours after symptoms resolve
severe reaction needing more than 2 doses of IM adrenaline
PMHx severe asthma
possibility of an ongoing reaction (e.g. slow release medicines)
patient presents late at night
patient does not live close to emergency services
investigation for contact dermatitis
skin patch test
