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Allergies and anaphylaxis
By Ben Green
Instructions
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AnaphylaxisBasic science
Anaphylaxis
Type 1 hypersensitivity reaction
Sudden onset immunological reaction
Following sensitisation to an allergen Often following the 3rd exposure
Mediated by IgE
Immunoglobulin E (IgE)Following sensitisation, exposure to an allergen can cause IgE binding via Fc receptors and subsequent degranulation of mast cells. This releases inflammatory mediators such as histamine and leukotrienes.
Histamine potentiates anaphylaxis, causing vasodilatation and tissue fluid leakage. This causes a range of symptoms including laryngeal oedema and circulatory shock, whilst leukotrienes are responsible for bronchoconstriction and wheeze/stridor.
Recognising anaphylaxis
Picture Quiza
The following slides list common symptoms of anaphylaxis!
Select the tab that matches the picture in order to advance!
Stridor/wheeze
Nausea/vomiting
AngioedemaShortness of breath
Cyanosis
ShockUrticaria
Common allergens
Stridor/wheeze
Nausea/vomiting
Shortness of breath
Cyanosis
ShockUrticaria
Common allergensAngioedema
Nausea/vomiting
Shortness of breath
Cyanosis
ShockUrticaria
Common allergensAngioedema
Stridor/wheeze
Stridor/wheeze
Nausea/vomiting
AngioedemaShortness of breath
Common allergens
ShockUrticaria
Cyanosis
Stridor/wheeze
Nausea/vomiting
AngioedemaShortness of breath
Common allergens
Shock
Cyanosis
Urticaria
Insects and stings
Anaphylaxis management
Insect and stings
Autoinjectors
Scenarios
Insects and stings
Wasp stings The wasp sting is easy to
insert, and easy to come out
Delivers 2-15mcg venomAlkaline
Treatment Remove sting Elevation Ice
Insects and stings
Bee stings The bee sting is barbed
and is harder to remove
Delivers 50mcg venomFormic/methanoic acid
Treatment Remove sting Elevation Ice
Match the insect to the ‘cure’
Match the insect to the ‘cure’
Bicarbonate for Bees
Match the insect to the ‘cure’
Vinegar for Vasps
Management of anaphylaxis
Your patient is unconscious following an anaphylactic reaction!
Select the correct order of treatment!
A wrong move returns you to the start!
Well done!
Having successfully treated your patient you decide to review the anaphylaxis guidelines to
make sure your treatment was correct!
UK Resuscitation Council Guidelines
UK Resuscitation Council Guidelines
Autoinjectors
Anapens
Deliver injection into outer thigh
3 different pens (dose varies with colour)
Delivers adrenaline
Hold in place for 10s
Massage for 10s
Epipens
Deliver injection into outer thigh
Delivers 0.3mg adrenaline
Hold in place for 10s
Massage for 10s
See video
Adrenaline and autoinjectors
True or false
Correctly answer a question to advance!
Adrenaline and autoinjectors
Adrenaline targets both alpha and beta adrenergic receptors!
FalseTrue
Adrenaline and autoinjectors
You must remove clothing and expose the skin before using the autoinjector!
True False
Adrenaline and autoinjectors
Adrenaline treats shock by causing peripheral vasoconstriction!
FalseTrue
Scenarios
Split into pairs
1 member wait outside the room…
Scenario 1 Scenario 2
Scenario 1
Information for patient...
You are complaining of nausea and light headedness (pass out after a minute or so)
A – NKDA M – salbutamol inhaler P – asthma L – scallops for starter E – at a restaurant
Scenario 1
Information for first aiders...
The casualty is looking pale and clammy
Upon examination has a weak rapid pulse
Scenario 2Information for patient...
Act slightly confused and complain of chest tightness (remain conscious throughout)
A – peanuts M – you have an epipen in your pocket P – none L – just eaten curry (unsure what was in it) E – at a friends house for dinner
Scenario 2
Information for first aiders...
You notice swelling around the patients face and lips
You notice the patient looks very flushed
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