1. Rare ……..But it could be YOU!
Anaphylaxis
Rare ……..But it could be YOU!

2. Diagnosis and Treatment of Anaphylaxis.
Symptoms:-
Sudden onset - faint light headed dizzy.
Tingling sensation, itching, metallic taste in mouth
sensation of warmth
vomiting diarrhoea abdominal cramp
cough wheezing nasal congestion
confusion slurred speech anxiety

3. Treatment of Anaphylaxis.
Signs - Sudden onset immediate to 24 hrs
Pale…reddened skin…... Cyanosed
wheezing swelling of upper airway.
Rapid weak pulse. Falling BP
Urticaria.
Sudden collapse.

4. Treatment of anaphylaxis
Adrenaline
Oxygen
Antihistamine
Hydrocortisone
possibly - IV fluids, beta agonist e.g. salbutamol esp if wheezing.

5. Treatment of Anaphylaxis
Adrenaline………..
ALWAYS IM Never IV or Sc.
Dosage - >12yrs - 1: ml IM
>12 yrs pre-pubertal or age 6 to 12 years : ml IM
6mths to 6yrs - 1: ml IM
<6mths - 1: ml IM
Allow 5 minutes then repeat dose.

6. Treatment of Anaphylaxis.
Oxygen - at maximum flow whenever available.
Antihistamine -chlorpheniramine - Piriton
Dose - >11yrs mg slow IV
6 to 11yrs - 5 to 10mg slow IV
1 TO 5Yrs - 2.5mg to 5mg slow IV

7. Treatment of Anaphylaxis
Hydrocortisone - dose-
>11yrs to 500mg slow IV or IM
6 to 11yrs 100mg slow IV or IM
1 to 5 yrs 50mg slow IV or IM
Consider IV fluids - use a crystalloid- eg Normal saline.
Dose- adults 1 to 2000ml IV stat
children - 20ml/kg rapid IV

8. Treatment of Anaphylaxis
Position Patient- if breathing ok Trendelenberg position.
- if wheezing sat upright.
Remember salbutamol for wheezing by nebuliser.
ADMIT ALL CASES - RISK OF RECURRENCE FOR UP TO 24 HRS.

9. Treatment of Anaphylaxis
Also consider…………..
If patient on tricyclic drug or MAOI then halve the dose of adrenaline.
If patient on beta blocker halve the dose of adrenaline.
If drug history unknown treat as per guideline.

10. Treatment Of Anaphylaxis
IM injections into antero-lateral part of upper thigh.
Always refer to Dr if on premises.
No Dr - send by 999 ambulance to Accident and Emergency.
Remember ABC of recussitation.
Bi-phasic response of anaphylaxis.

11. Contra-indications to Vaccination
Child unwell - febrile on abiotics etc
previous vaccine reaction.
Remember eggs - MMR FLU?
Child refuses vaccination.
Doubts about correct vaccine/need to vaccinate.
Vaccine specific reasons not to vaccinate.

12. Treatment of Anaphylaxis
Documentation - full record of symptoms and treatment.
Document medication fully
The good news -anaphylaxis is rare and if diagnosed and managed quickly is eminently treatable.
So patient information important!!

13. Treatment of Anaphylaxis.
Remember the three Rs
1) Recognise symptoms.
2) Respond quickly.
3) Review and prevent Recurrence.