Transcript 451_Chap

CHAPTER 20
Allergic
Reactions
Assessment of Allergic
Reactions
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.
Allergen:
A substance that commonly
causes allergic reactions, such as
insect bites or stings, foods,
plants, and medications.
Causes of
Allergic Reactions
Common Allergens
Insect
bites
Foods
Plants
Meds
Insect
stings
Always check for a medical
alert bracelet or necklace carried
by people who have severe
allergic reactions.
Signs and Symptoms
of Allergic Reactions
Allergic reactions can
result in a variety of
signs and symptoms.
Signs & Symptoms of
Allergic Reactions

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
Allergic Reactions
continued

Tingling in face, mouth, chest,
hands and feet

Body swelling and rash

Itchy, watery eyes

Patient may feel uncomfortable and
display odd behavior

Headache
Respiratory distress and
hypoperfusion are the most serious
complications of allergic reactions...
…when these signs and
symptoms are present, immediate
intervention may be needed.
Remember that the earliest sign
of hypoperfusion is a change in
the mental status of the
patient.
Emergency Care for Patients
with Allergic Reactions
Airway Interventions
Patients with mild allergic
reactions should be transported
and observed for changes in status.
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
Airway
Management
Treat the patient with severe
respiratory distress secondary to
allergic reaction aggressively...
…high flow O2 and airway
management techniques, including
BVM, may be necessary.
Reassessing the airway of a
patient with an allergic reaction
is a TOP PRIORITY!
Administration of
Medication
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.
Autoinjector:
A device that administers a
preset dose of medication in a
safe manner, by way of
intramuscular self-injection.
The
Epinephrine
Autoinjector
Criteria for
Epinephrine Autoinjector

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
There are NO
CONTRAINDICATIONS
to epinephrine in a lifethreatening emergency!
Use of the Autoinjector
Obtain authorization.
Use of the Autoinjector continued
Remove the safety cap.
Use of the Autoinjector continued
Place tip at 90-degree
angle against thigh.
Common Epinephrine Side Effects

Increased heart rate and
blood pressure

Pale skin

Dizziness

Chest pain

Headache
Continue to reassess the
patient every 5 minutes
after epinephrine injection!
RAPID TRANSPORT
IS ESSENTIAL!
Some patients may also
carry an antihistamine,
known as Benadryl, for mild
allergic reactions.
SUMMARY

Assessment of Allergic
Reactions

Emergency Care for Patients
with Allergic Reactions