anafilaxia

22

A AnaphylaxisRespiRatoRy DistRess anD CaRDiovasCulaR Collapse

Present History onset; dyspnea; inability to swallow saliva; urticaria; rash; recent ingested medications; known food aller-gens or unusual food recently ingested; epinephrine kit used; nausea; vomiting; cramping; feeling of impending doom

Past History diabetes; heart disease; asthma; previous severe episodes; allergies

Medications prescribed/OTC; new medications; recent antibiotic ingestion; time of last dose

Physical Exam Initialassessment Vitalsigns Airway:angioedema Breathing:stridor;wheezing;cough;hyperpnea Circulation:hypotension;tachycardia Skin:diaphoretic;urticaria Mentalstatusexamination:confusion

Treatment Severereactionsrequireimmediateepinephrine

administration. Administration:SQ, IV, IM, or ET (route, amount, time of

first dose, repeat treatment per protocol) Airwaymanagement:oralairway;oropharyngealsuction;

ET intubation (placement verification, tube size, secured); nasal or oropharyngeal intubation

Breathing:capnometer;pulseoximetry;oxygen(rate,method of administration)

85413_ch00_Book_6141.indd 22 4/6/12 1:32:21 PM

Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.

Jones & Bartlett Learning, LLCNOT FOR SALE OR DISTRIBUTION




















23A

Circulation:IV therapy (fluid, amount, rate, bolus, cath size, number of lines, site, attempts)

Cardiacmonitoring Antihistamines per local protocol

Monitor continuedassessment

Medical Control ContactregardingETA,changeinstatus,ordeviationfromprotocol.

Tips EpinephrinecanbeinjectedintothebaseofthetongueorviatheETtubeinanaphylaxisifIVaccessorETintubationisnotpossible(checklocalprotocol).Epinephrineisthedrugofchoiceforseverereactions.

85413_ch00_Book_6141.indd 23 4/6/12 1:32:21 PM

Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION.





















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