ANAPHYLAXIS
Prepared by:
South West Education Committee
South West Education Committee
Anaphylaxis Protocol
SWEC MEMBERS
Cambridge – Lori Smith Grey Bruce – Andy Whittemore Hamilton – Ken Stuebing, Tim Dodd Lambton – Judy Potter London – Tre Rodriguez Niagara – Greg Soto Windsor – Cathie Hedges RTN – Peter Deryk
“The Power of 7” Base Hospital Programs
Goal: One single certification for all of SouthWestern Ontario by Fall 2005!!
Recert process same across SW this year. Notice, all paperwork will say SWEC. Some information may not be specific to
Hamilton BH or Services in our area. Pictures for data base in one of the stations
OBJECTIVES
Review basic pathophysiology of Anaphylaxis
Review Anaphylaxis. At the end of this session you should be
able to describe and explain: Anaphylaxis and its’ treatment protocols.
ANAPHYLAXIS
An immediate, systemic, life-threatening allergic reaction associated with major changes in the cardiovascular, respiratory and cutaneous systems.– Prompt recognition and appropriate drug
therapy are important to patient survival.
Pathophysiologyof anapnylactic shock.PATHOPHYSIOLOGY
A, B, C, … Assess the patient’s… Airway (do they have
one? Can they maintain it?
Breathing (are they) Circulation (pulses) ECG (Is the monitor
on?)
ASSESSMENT
What is the patients chief complaint?
Possible anaphylaxis?
If “NO” then assess treat & transport.
If ‘YES” get a Hx.
REVIEW
Chief Complaint– One or more symptoms for which the patient
is seeking medical care– Most chief complaints are characterized by:
• Pain• Abnormal function• A change in the patient's normal state• An unusual observation made by the patient (e.g.,
heart palpitations)
REVIEW
Chief Complaint– Be alert to the possibility that a chief
complaint may be misleading or that a problem may be more serious than the patient's chief complaint
The patient – May not be exactly sure what is bothering
him/her
ANAPHYLAXIS
If you suspect anaphylaxis then:
Get a history of present illness (HPI).
Be thorough, yet time efficient.
REVIEW
History of Present Illness (HPI)– Identifies the chief complaint and provides
a full, clear, chronological account of the symptoms
– A thorough HPI requires skill in:• Asking appropriate questions related to
the chief complaint• Interpreting the patient's response to
those questions
ANAPHYLAXIS
Assess/obtain the patients vitals.– Level of
Consciousness– Blood Pressure– Pulse/ECG– Respiratory rate– Capillary refill– SpO2 reading– Skin
ALLERGIES
Did you ask about allergies?
Did you look for a medical alert tag?
If unconscious, check for a medic alert tag.
ANAPHYLAXIS – S&S Wheezing Stridor Hypotension (systolic less than 90) Decreased LOC Airway compromise Edema Urticaria ( with at least one of the above)
ANAPHYLAXIS ?
Does your exam identify:
Generalized urticaria?
Generalized or local edema?
Urticariaas a result of an allergic reaction.What does Urticaria look like?
TUNNEL VISION Generalized urticaria!!! How is the patients airway?
ANAPHYLAXIS - SOB
On exam do you note/observe any of the following?
Wheezing? Stridor? Shortness of
breath?
ANAPHYLAXIS - SOB
If yes, then begin treatment.
Remember urticaria must be accompanied with wheezing and/or stridor, etc.
ANAPHYLAXIS - TREATMENT
Oxygen–NRB @ 15 L/min.
Epinephrine 1:1000 If 30 kg give
0.3 mg If 30 kg give
0.1 mg/10 kg rounding to nearest 0.05 mg.
WHY EPINEPHRINE?
Increases vascular smooth muscle tone (alpha agonist).
Decreases tone in alveolar smooth muscle (beta agonist).
ANAPHYLAXIS TREATMENT
Reassess patient Be prepared to
control their airway.
BVM Suction
ANAPHYLAXIS TREATMENT
Repeat Epi x 1 if: Condition does
not improve after 10 minutes.
Patient deteriorates.
ANAPHYLAXIS TREATMENT
Remember OMITR
Oxygen Monitor Intervention(s) Transport ASAP Reassess often
SUMMARY
If patient has self-administered, follow the rules for a second administration
Following 1st Epi. If wheezing develops or is present consider the SOB protocol.
Urticaria alone is not an indicator for Epi.!
QUESTIONS?