Special Circumstances Workshop Anaphylaxis

By the end of this session the candidate will: Understand the approach to the patient with anaphylaxis Recognise the signs and symptoms of anaphylaxis Know how to manage the patient with anaphylaxis Understand the role of IM adrenaline Understand the potential complications of IV adrenaline and the indications for its use Learning outcomes

Possible antigens Food products Nuts Red fruits Shellfish Insect envenomation Animal hair/mites Medications Muscle relaxants Antibiotics NSAIDS/Aspirin Anti-venom Colloid infusions Blood transfusion Contrast dyes Risk of death increased with pre-existing asthma or delayed treatment

Case study Clinical setting and history An American tourist has walked in to your hospital after having had a curry at a local restaurant. Despite asking for a meal with no nuts, he is sure that he could taste some in the curry. He claims to have a “nut allergy” and he feels a bit tight-chested. On examination, there is little abnormal to find apart from a slightly increased respiratory rate. Clinical course ABCDE -A : Clear -B : RR 18 min -1 -C : P 90 min -1, BP 110/60 mmHg -D : Alert, anxious -E : Normal What will you do now?

Case study (continued) Clinical course Over the next 10 min, he becomes very short of breath, has widespread wheeze, develops an urticarial rash, and feels light headed. ABCDE -A : Complains of tightness in throat -B : RR 28 min -1, widespread wheeze -C : P 120 min -1, BP 80/60 mmHg -D : Very anxious -E : Widespread urticaria What will you do now?

Any questions?

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