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It potentially involves some of the following symptoms and signs: 1, 2, 8 Epinephrine Administration and DosingĪnaphylaxis has a sudden onset (minutes to a few hours) after exposure to a food, drug, insect sting, or other trigger.
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1, 2, 8, 25, 27, 28 For children with concomitant asthma, inhaled β2-adrenergic agonists (eg, albuterol) can provide additional relief of lower respiratory tract symptoms but, like antihistamines and glucocorticoids, are not appropriate for use as the initial or only treatment in anaphylaxis. 1, 2, 16, – 18 H 1-antihistamines prevent and relieve itching and hives but do not relieve life-threatening respiratory symptoms, hypotension, or shock 1, 2, 4, 8, 25, 26 therefore, like H 2-antihistamines and glucocorticoids, they are adjunctive treatments and are not appropriate for use as the initial treatment or the only treatment. 16, , – 18 Conversely, prompt prehospital epinephrine injection is associated with a lower risk of hospitalization 22 and fatality. 3ĭelayed epinephrine administration in anaphylaxis is associated with an increased risk of hospitalization 22 and poor outcomes, including hypoxic-ischemic encephalopathy and death. Reduced blood pressure after exposure to a known allergen for that patient (minutes to several hours): (1) for infants and children, low systolic blood pressure (age-specific) or greater than 30% decrease in systolic blood pressure, and (2) for teenagers and adults, systolic blood pressure of less than 90 mm Hg or greater than 30% decrease from that person’s baseline. Two or more of the following that occur suddenly after exposure to a likely allergen for that patient (minutes to several hours): (1) involvement of the skin/mucosal tissue (eg, generalized urticaria, itch/flush, swollen lips/tongue/uvula), (2) respiratory compromise (eg, dyspnea, wheeze/bronchospasm, stridor, hypoxemia), (3) reduced blood pressure or associated symptoms (eg, hypotonia, syncope, incontinence), or (4) persistent gastrointestinal symptoms (eg, crampy abdominal pain, vomiting) OR Key points emphasized include the following: (1) validated clinical criteria are available to facilitate prompt diagnosis of anaphylaxis (2) prompt intramuscular epinephrine injection in the mid-outer thigh reduces hospitalizations, morbidity, and mortality (3) prescribing EAs facilitates timely epinephrine injection in community settings for patients with a history of anaphylaxis and, if specific circumstances warrant, for some high-risk patients who have not previously experienced anaphylaxis (4) prescribing epinephrine for infants and young children weighing <15 kg, especially those who weigh 7.5 kg and under, currently presents a dilemma, because the lowest dose available in EAs, 0.15 mg, is a high dose for many infants and some young children (5) effective management of anaphylaxis in the community requires a comprehensive approach involving children, families, preschools, schools, camps, and sports organizations and (6) prevention of anaphylaxis recurrences involves confirmation of the trigger, discussion of specific allergen avoidance, allergen immunotherapy (eg, with stinging insect venom, if relevant), and a written, personalized anaphylaxis emergency action plan and (7) the management of anaphylaxis also involves education of children and supervising adults about anaphylaxis recognition and first-aid treatment.Īcute onset of an illness (minutes to several hours), with involvement of the skin, mucosal tissue, or both (eg, generalized urticaria, itching or flushing, swollen lips/tongue/uvula), and at least 1 of the following: (1) respiratory compromise (eg, dyspnea, wheeze/bronchospasm, stridor, hypoxemia) or (2) reduced blood pressure or associated symptoms of end-organ dysfunction (eg, hypotonia, syncope, incontinence) OR The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs).
First aid 2017 drugs quizlet update#
This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death.