Module 17: allergies and anaphylaxis

Question 1

What is an allergic reaction?

Answer 1

Immune response to an agent

Question 2

What is anaphylaxis?

Answer 2

extreme, life threatening allergic reaction that may cause swelling to lips and tongue, cardiovascular collapse, respiratory failure and/or shock.

Question 3

Most deaths from anaphylaxis occur within ___ minutes

Answer 3

thirty

Question 4

If the body determines that an antigen is a threat, the body will…

Answer 4

mount an inflammatory response and release chemical mediators (ex. histamine, leukotrienes)

Question 5

What lung sounds may be heard during anaphylaxis? Why?

Answer 5

Wheezing, due to vasoconstriction and bronchospasm that may occur during anaphylaxis

Question 6

Describe how the heart may react during anaphylaxis?

Answer 6

decreased output, decreased coronary flow.

Question 7

How might blood vessels react during anaphylaxis?

Answer 7

vasodilation and leakiness.

Question 8

Why is it important for the EMT to remain suspicious during a possible allergic reaction?

Answer 8

Pt may not know they have an allergy, especially because the first time you are exposed to something they may not have a reaction.

Question 9

Describe the consequences of these responses
vasodilation
bronchoconstriction
capillary leaking
swelling to upper airway

Answer 9

vasodilation=hypotension
bronchoconstriction= wheezing
capillary leaking= hypotension
swelling to upper airway= stridor

Question 10

Name symptoms of cardiovascular collapse

Answer 10

Low BP
Face, lips, tongue swelling
Dizziness

Question 11

Name symptoms of respiratory distress during anaphylaxis

Answer 11

Wheezing
Stridor
Dyspnea

Question 12

In the setting of a known exposure to an allergen associated GI symptoms, consider anaphylaxis in consult with ____

Answer 12

medical control

Question 13

How should you remove a stinger?

Answer 13

A credit card, scraping back and forth

Question 14

Can you repeat an epi dose? When?

Answer 14

Yes, five minutes if symptoms are not improving. This is on standing order.

Question 15

Where on the thigh should epi be adminstered?

Answer 15

Anterior lateral thigh

Question 16

Name the epinephrine dose for adults and children? state both mg and mL

Answer 16

adults (>=66)=0.3 mg or 0.3mL
kids (<66)=0.15 or 0.15mL

Question 17

What are the three symptoms of anaphylaxis in patients that do NOT have a history of anaphylaxis EMTs may administer epi for?

Answer 17

Severe respiratory distress
Hypoperfusion
Facial/oral edema

Question 18

What are the four symptoms of anaphylaxis in patients that DO have a history of anaphylaxis EMTs may administer epi for?

Answer 18

Severe respiratory distress
Hypoperfusion
Facial/oral edema
RASH

Question 19

For autoinjectors, how long should they be held into thigh?

Answer 19

three seconds

Question 20

If patient is wheezing, you may adminster ____. __ doses are permissible, but it should be administered ____ epinephrine.

Answer 20

albuterol, three, after

Question 21

When should you request ALS if you suspect anaphylaxis?

Answer 21

ASAP

Question 22

A raised, swollen, well-defined area on the skin that is the result of an insect bite or sting is called:
purpura
uriticaria
a wheal
a pustule

Answer 22

wheal

Question 23

What is the most common trigger for anaphylaxis?
medications
chemicals
plants
food

Answer 23

food

Question 24

You administered one dose of epinephrine at 1012hrs to a 20-year-old female to treat suspected anaphylaxis that she developed after being stung by a bee. Your reassessment at 1017hrs reveals that she is still having difficulty breathing, has a decreasing mental status, and has a BP of 80/50 mm Hg. You should:

Answer 24

give another dose of epinephrine on standing order

Question 25

Chemicals that are responsible for the signs and symptoms of an allergic reaction to a bee sting are called
adrenaline and histamines
the bee venom itself
histamines and leukotrienes
leukocytes and epinephrine

Answer 25

histamines and leukotrienes

Question 26

You are called to a 22-year-old male who is experiencing hives after eating peanuts. He denies any allergies.

His lung sounds are clear, his blood pressure is 110/72, his heart rate of 102, and his respirations are 20. He is complaining of being “really itchy”. Which of the following choices would be your best treatment plan per NYS protocol?
administer epinephrine
monitor and transport pt
administer albuterol

Answer 26

monitor and transport pt

Question 27

Which lung sound indicates swelling of the upper airway?

Answer 27

stridor