1. Allergic Reactions CHAPTER 20

2. Assessment of Allergic Reactions

3. Allergic reaction: An exaggerated immune response to a substance that comes into contact with the body. A severe allergic reaction is called anaphylaxis or an anaphylactic reaction.

4. Allergen: A substance that commonly causes allergic reactions, such as insect bites or stings, foods, plants, and medications.

5. Causes of Allergic Reactions

6. Common Allergens Foods Insect bites Insect stings Plants Meds

7. Always check for a medical alert bracelet or necklace carried by people who have severe allergic reactions.

8. Signs and Symptoms of Allergic Reactions

9. Allergic reactions can result in a variety of signs and symptoms.

10.  Increased heart rate  Decreased blood pressure  Coughing, stridor, wheezing or noisy respirations  Rapid, labored breathing  Tightness in the throat, hoarseness  Hives (urticaria)  Itchy, red or flushed skin Signs & Symptoms of Allergic Reactions

11.  Tingling in face, mouth, chest, hands and feet  Body swelling and rash  Itchy, watery eyes  Patient may feel uncomfortable and display odd behavior  Headache Allergic Reactions continued

12. Respiratory distress and hypoperfusion are the most serious complications of allergic reactions... …when these signs and symptoms are present, immediate intervention may be needed.

13. Remember that the earliest sign of hypoperfusion is a change in the mental status of the patient.

14. Emergency Care for Patients with Allergic Reactions Airway Interventions

15. Patients with mild allergic reactions should be transported and observed for changes in status.

16. Serious Signs or Symptoms  History  Focused and brief  Previous reactions and severity  Medications available for reaction, tablets or epinephrine autoinjector  Physical examination  Baseline vital signs  Signs of allergic reaction

17. Airway Management

18. Treat the patient with severe respiratory distress secondary to allergic reaction aggressively... …h igh flow O 2 and airway management techniques, including BVM, may be necessary.

19. Reassessing the airway of a patient with an allergic reaction is a TOP PRIORITY!

20. Administration of Medication

21. Epinephrine: A medication used to dilate the bronchioles, prevent tissue swelling, constrict the blood vessels and increase the ability of the heart to pump blood.

22. Autoinjector: A device that administers a preset dose of medication in a safe manner, by way of intramuscular self-injection.

23. The Epinephrine Autoinjector

24.  Assessment reveals a patient with a severe allergic reaction  Respiratory compromise and/or hypoperfusion  Medication has been prescribed for this patient by a physician  Medical direction authorizes use for this patient  Expiration date current Criteria for Epinephrine Autoinjector

25. There are NO CONTRAINDICATIONS to epinephrine in a life- threatening emergency!

26. Use of the Autoinjector Obtain authorization.

27. Use of the Autoinjector continued Remove the safety cap.

28. Use of the Autoinjector continued Place tip at 90-degree angle against thigh.

29. Common Epinephrine Side Effects  Increased heart rate and blood pressure  Pale skin  Dizziness  Chest pain  Headache

30. Continue to reassess the patient every 5 minutes after epinephrine injection! RAPID TRANSPORT IS ESSENTIAL!

31. Some patients may also carry an antihistamine, known as Benadryl, for mild allergic reactions.

32. SUMMARY Assessment of Allergic Reactions Assessment of Allergic Reactions Emergency Care for Patients with Allergic Reactions Emergency Care for Patients with Allergic Reactions