1. Anaphylaxis Be Prepared not Panicked Karen Andrews MD

2. Successful management of Anaphylaxis Understand what is happens during an anaphylactic reaction Risk factors for fatal anaphylaxis Signs and symptoms of anaphylaxis Feel comfortable using epinephrine

3. What Happens in an Allergic Reaction

4. Fatal Anaphylaxis Triggers #1 Medications- older adults #2 Foods- cows milk in younger children, peanuts and tree nuts in young adults/adolescents #3 Insect stings-older adults Other: latex, parasites

5. Characteristics Fatalities occur within 60 minutes in most cases Dose 1gm of a nut versus 10gm of other foods Respiratory arrest in food allergy reactions Cardiovascular collapse in venom and medication reactions

6. Factors that Can Influence Severity Dose of allergen Other illness ie fever, asthma exacerbation Medications – Beta blockers, ACE inhibitors, aspirin, ibuprofen Exercise Alcohol Hormones

7. Risk Factors for Fatal Anaphylaxis Asthma Delayed or No Epinephrine Upright posture Misdiagnosis Carelessness about avoidance

8. Signs and Symptoms

9. Recognizing Anaphylaxis in Infants

10. Anaphylaxis can be confused with: Asthma Choking Panic attack & Anxiety Fainting Heart attack Seizure, Stroke Scromboidosis

11. Diagnostic Criteria for Anaphylaxis

12. Prevention of Fatal Reactions Train Practice- monthly Carry injectable epinephrine Educate others

13. Treatment of Anaphylaxis Epinephrine, Epinephrine, Epinephrine Lay Down ABC’s & Activate EMS Other medications that can be given – H1 Blocker ie Zyrtec or Benadryl – H2 Blocker ie ranitidine – Rescue inhalers – Steroids

14. Post Anaphylaxis Care Be aware of biphasic anaphylaxis Continue oral steroid and anti-histamine for at least 48 hours after the reaction Refill injectable epinephrine