Anaphylactic reactions

1
Anaphylactic reactions and the Drug Box
Lunchtime Drop in Sessions week Beginning 27th
Nov (Not Friday) see Nick
2
Anaphylactic reactions and the Drug Box
3
Anaphylactic reactions

• Anaphylactic reactions are the immediate type of
  hypersensitivity that result from interaction of
  antigens with specific antibodies bound to mast
  cells and basophils.
• They involve the release of vasoactive
  bronchoconstrictive substances such asHistamine,
  Leukotrienes, Chemotactic factors.

4
Recognition - First observed signs

• Difficulty inflating lungs
• Flushing
• Coughing
• Rash
• Desaturation
• No pulse/ fall in BP
• Cyanosis
• Others (ECG changes, swelling, urticaria)

5
Patient symptoms

• Vomiting
• Cramping tummy pains
• A tingling feeling in the lips or mouth
• Faintness with a nettlerash or swelling coming on
  quickly is probably anaphylaxis, and if there is
  also difficulty in breathing the danger is
  greater.
• Faintness with difficulty in breathing alone will
  sometimes be due to a panic attack, but can also
  be due to anaphylaxis.

6
Recognition

• Examination of the skin may show hives and
  swelling of the eyes or face.
• The skin may be blue from lack of oxygen or may
  be pale from shock.
• Angioedema in the throat may be severe enough to
  block the airway.

7
Primary management

• Stop drug
• Maintain the venous access
• 100 O2 and maintain airway
• Get help
• Lay patient flat with legs elevated

8
Whats in the box?
9
Did you check the box?
10
Can you read this?
11
Chlorphenamine

• Antihistamine
• 10mg in 1ml

12
Adrenaline / Epinephrine

• 1mg in 1 ml

13
Hydrocortisone

• Anti inflammatory
• 100mg in 1 ml when reconstituted

14
Water for Injection
15
What's not in the box?

• You will need at least
• 1 x 5ml syringe
• 2 x 1ml syringe
• 3 Pink straight needles
• Saline for flushing

16
Mixing the Hydrocortisone

• Use a 5 ml syringe
• Open 1 2ml ampoule of water for injection
• Use a long enough needle to draw up the whole
  ampoule
• Remove yellow cap from cortisone ampoul
• Hold the syringe upright and insert through
  cortisone ampoule bung
• Withdraw 2 mls of air
• Invert ampoule and syringe and inject water into
  ampoul
• Without removing needle mix well
• Draw up mixed fluid into syringe

17

• Now replace the box immediately from pharmacy