Anaphylaxis (Adult)

Status
• Evidence of anaphylaxis • Exposure to foreign antigen
Assess for Systemic Involvement:
Angio-oedema or
Urticaria or
GIT disturbance
Plus at least one of the following:
Assess Physiological Distress:
Respiratory distress / bronchospasm or
Less than Adequate Perfusion or
Altered Conscious State

Mild Anaphylaxis No Physiological Distress Local allergic reaction e.g. red rash / itchy BLS

Moderate Anaphylaxis Less than Adequate to Inadequate Perfusion Monitor Pt for cardiac arrhythmias Adrenaline 300mcg IM (1:1,000) - Repeat Adrenaline 300mcg IM, 5 minutely until satisfactory results or side effects occur. Treat bronchospasm as per Asthma: Mild/Moderate/Severe Consider fluid as per Hypovolaemia Dexamethasone 8mg IV

Severe Anaphylaxis Extremely Poor Perfusion Treat as per Moderate Adrenaline 50 mcg IV (1 : 10,000) - Repeat Adrenaline 50-100 mcg IV, 1 minutely until satisfactory results or side effects occur IV fluid as per Hypovolaemia Dexamethasone 8mg IV If no IV access Mx as per Moderate If no IV access consider I/O If intubated - Adrenaline 200mcg via ETT 5 minutely

Special Notes

All Pts with suspected anaphylaxis must be transported to hospital regardless of the severity of their presentation or response to management.

Angio-oedema (vascular oedema) leads to increased tissue fluid, presenting as swelling, upper airway obstruction (throat tightness), orbital oedema and other systemic signs of swelling.

Identify history of exposure to substances known to cause anaphylactic reaction, e.g. recent insect bite, medications, exposure to food known to cause anaphylactic reaction and presenting with evidence of systemic involvement.

Research indicates most deaths from anaphylaxis occurred with a delay in administration of Adrenaline in severe reactions.