RRAPID: Anaphylaxis

Question 1

Features to recognise for? (8)

Answer 1

Sudden onset and rapid progression of symptoms:
Rash
Urticaria 
Laryngeal oedema (coughing, chocking, stridor)
Angio-oedema
Severe bronchospasm
Hypotension and shock
N&V or diarrhoea

Question 2

Airway Mx? (4)

Answer 2

Secure the airway
Give 15L Oxygen via a reservoir mask
Call an anaesthetist if airway compromised
CALL FOR HELP

Question 3

Circulation Mx? (4)

Answer 3

Lay patient flat & raise legs
IV access: bloods (FBC, U&E’s, LFT’s, calcium & glucose)
Fluid bolus: 500ml Hartmann’s or 0.9% Saline over 30 mins
ECG

Question 4

Medication Mx?

Answer 4

IM Adrenaline 0.5 mls of 1:1000 (500 mcg)
Repeat adrenaline as necessary every 5 mins (check BP and pulse)
IV Chlorphenamine 10 mg (slow) (may continue for 24-48hrs for urticaria and pruritis)
IV Hydrocortisone 200 mg (slow)

Question 5

What do if audible wheeze during breathing (recognition) ?

Answer 5

Treat for asthma : salbutamol

Question 6

What may be required to maintain BP?

Answer 6

Inotropes/vasopressors

Question 7

If patient remains unstable consider what?

Answer 7

Transfer to ICU