Allergic Reactions CHAPTER 20. Assessment of Allergic Reactions.

Allergic Allergic ReactionsReactions

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Assessment of Allergic Assessment of Allergic ReactionsReactionsAssessment of Allergic Assessment of Allergic ReactionsReactions

Allergic reaction:Allergic reaction:

An exaggerated immune An exaggerated immune response to a substance that response to a substance that comes into contact with the comes into contact with the body.body.

A severe allergic reaction is called anaphylaxis or an anaphylactic reaction.

Allergen:Allergen:

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

Causes of Causes of Allergic ReactionsAllergic Reactions

Causes of Causes of Allergic ReactionsAllergic Reactions

Common AllergensCommon Allergens

FoodsInsectbites

Insectstings

Plants

Meds

Always check for a

medical alert bracelet or

necklace carried by

people who have severe

allergic reactions.

Signs and SymptomsSigns and Symptomsof Allergic Reactionsof Allergic ReactionsSigns and SymptomsSigns and Symptomsof Allergic Reactionsof Allergic Reactions

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

Increased heart rateIncreased heart rate

Decreased blood pressureDecreased blood pressure

Coughing, stridor, wheezing or noisy respirationsCoughing, stridor, wheezing or noisy respirations

Rapid, labored breathingRapid, labored breathing

Tightness in the throat, hoarsenessTightness in the throat, hoarseness

Hives Hives (urticaria)(urticaria)

Itchy, red or flushed skinItchy, red or flushed skin

Signs & Symptoms of Allergic Reactions Signs & Symptoms of Allergic Reactions

Tingling in face, mouth, chest, hands and feetTingling in face, mouth, chest, hands and feet

Body swelling and rashBody swelling and rash

Itchy, watery eyesItchy, watery eyes

Patient may feel uncomfortable and display odd behaviorPatient may feel uncomfortable and display odd behavior

HeadacheHeadache

Allergic Reactions continued Allergic Reactions continued

Respiratory distress and Respiratory distress and hypoperfusion are the most hypoperfusion are the most serious complications of allergic serious complications of allergic reactions...reactions...

……when these signs and when these signs and symptoms are present, symptoms are present,

immediate intervention may immediate intervention may be needed.be needed.

Remember that the earliest Remember that the earliest

sign of hypoperfusion is a sign of hypoperfusion is a

change in the change in the mental statusmental status

of the patient.of the patient.

Emergency Care for Emergency Care for Patients with Allergic Patients with Allergic ReactionsReactions

Emergency Care for Emergency Care for Patients with Allergic Patients with Allergic ReactionsReactions

Airway InterventionsAirway Interventions

Patients with mild allergic

reactions should be

transported and observed for

changes in status.

Serious Signs or Symptoms Serious Signs or Symptoms

HistoryHistory Focused and briefFocused and brief Previous reactions and severityPrevious reactions and severity Medications available for reaction, tablets or epinephrine autoinjectorMedications available for reaction, tablets or epinephrine autoinjector

Physical examinationPhysical examination Baseline vital signsBaseline vital signs Signs of allergic reactionSigns of allergic reaction

Airway Airway ManagementManagement

Airway Airway ManagementManagement

Treat the patient with severe Treat the patient with severe

respiratory distress secondary to respiratory distress secondary to

allergic reaction aggressively...allergic reaction aggressively...

……hhigh flow Oigh flow O22 and airway and airway

management techniques, management techniques,

including BVM, may be including BVM, may be

necessary.necessary.

Reassessing the airway of a Reassessing the airway of a

patient with an allergic patient with an allergic

reaction is areaction is a TOP TOP

PRIORITY!PRIORITY!

Administration of Administration of MedicationMedication

Administration of Administration of MedicationMedication

Epinephrine:Epinephrine:

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

Autoinjector:Autoinjector:

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

The Epinephrine Autoinjector

Assessment reveals a patient with a Assessment reveals a patient with a severe allergic reaction severe allergic reaction Respiratory compromise and/or hypoperfusionRespiratory compromise and/or hypoperfusion

Medication has been prescribed for this patient by a physicianMedication has been prescribed for this patient by a physician

Medical direction authorizes use for Medical direction authorizes use for this patientthis patient

Expiration date currentExpiration date current

Criteria for Epinephrine Autoinjector Criteria for Epinephrine Autoinjector

There are There are NO NO

CONTRAINDICATIONSCONTRAINDICATIONS

to epinephrine in a life-to epinephrine in a life-

threatening emergency!threatening emergency!

Use of the Autoinjector

Obtain Obtain authorization.authorization.Obtain Obtain authorization.authorization.

Use of the Autoinjector continued

Remove the safety Remove the safety cap.cap.Remove the safety Remove the safety cap.cap.

Use of the Autoinjector continued

Place tip at 90-Place tip at 90-degree angle degree angle against thigh.against thigh.

Place tip at 90-Place tip at 90-degree angle degree angle against thigh.against thigh.

Common Epinephrine Side Effects Common Epinephrine Side Effects

Increased heart rate and Increased heart rate and blood pressureblood pressure

Pale skinPale skin

DizzinessDizziness

Chest painChest pain

HeadacheHeadache

Continue to reassess the Continue to reassess the

patient every patient every 5 minutes5 minutes

after epinephrine after epinephrine

injection!injection!RAPID TRANSPORT

IS ESSENTIAL!

Some patients may also

carry an antihistamine,

known as Benadryl, for

mild allergic reactions.

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ReactionsReactions

Emergency Care for Patients Emergency Care for Patients with Allergic Reactionswith Allergic Reactions