ANAPHYLAXIS
Prepared by:
South West Education
Committee
Anaphylaxis Protocol
South West Education Committee
SWEC MEMBERS
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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
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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
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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
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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.
Pathophysiology of anapnylactic shock.
PATHOPHYSIOLOGY
A, B, C, …
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Assess the patient’s…
Airway (do they have
one? Can they
maintain it?
Breathing (are they)
Circulation (pulses)
ECG (Is the monitor
on?)
ASSESSMENT
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What is the patients
chief complaint?
Possible
anaphylaxis?
If “NO” then assess
treat & transport.
If ‘YES” get a Hx.
REVIEW
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Chief Complaint
– One or more symptoms for which the patient
is seeking medical care
– Most chief complaints are characterized by:
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Pain
Abnormal function
A change in the patient's normal state
An unusual observation made by the patient (e.g.,
heart palpitations)
REVIEW
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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
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The patient
– May not be exactly sure what is bothering
him/her
ANAPHYLAXIS
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If you suspect
anaphylaxis then:
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Get a history of
present illness
(HPI).
Be thorough, yet
time efficient.
REVIEW
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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
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Assess/obtain the
patients vitals.
– Level of
Consciousness
– Blood Pressure
– Pulse/ECG
– Respiratory rate
– Capillary refill
– SpO2 reading
– Skin
ALLERGIES
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Did you ask about
allergies?
Did you look for a
medical alert tag?
If unconscious,
check for a medic
alert tag.
ANAPHYLAXIS – S&S
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Wheezing
Stridor
Hypotension (systolic less than 90)
Decreased LOC
Airway compromise
Edema
Urticaria ( with at least one of the above)
ANAPHYLAXIS ?
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Does your exam
identify:
Generalized
urticaria?
Generalized or
local edema?
What does Urticaria look like?
U rticaria as a result of an allergic reaction.
TUNNEL VISION
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Generalized urticaria!!!
How is the patients airway?
ANAPHYLAXIS - SOB
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On exam do you
note/observe any
of the following?
Wheezing?
Stridor?
Shortness of
breath?
ANAPHYLAXIS - SOB
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If yes, then begin
treatment.
Remember
urticaria must be
accompanied with
wheezing and/or
stridor, etc.
ANAPHYLAXIS - TREATMENT
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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?
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Increases vascular
smooth muscle tone
(alpha agonist).
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Decreases tone in
alveolar smooth
muscle (beta
agonist).
ANAPHYLAXIS
TREATMENT
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Reassess patient
Be prepared to
control their
airway.
BVM
Suction
ANAPHYLAXIS
TREATMENT
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Repeat Epi x 1 if:
Condition does
not improve after
10 minutes.
Patient
deteriorates.
ANAPHYLAXIS
TREATMENT
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Remember
OMITR
Oxygen
Monitor
Intervention(s)
Transport ASAP
Reassess often
SUMMARY
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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?