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Allergic Reactions | Anaphylactic Shock

Signs and Symptoms of Anaphylactic Shock

  • Sense of agitation, confusion, decreased LOC
  • Swelling of soft tissues like hands tongue and pharynx Wheezing, rales, rhonchi
  • Tingling, burning, itching skin
  • Abdominal pain
  • Tachycardia
  • Weak, thready pulse
  • Profound hypotension (late sign)
  • Weakness
  • Diaphoresis
  • Cyanosis
  • Peripheral edema

Moderate and Severe Reactions:

  • Aggressive airway management
  • Ventilatory support
  • Oxygen therapy
  • Circulatory support
  • Epinephrine .3-.5 mL subcutaneous if:
    • Wheezing or stridor
    • Edema of the pharynx, tongue or soft palate
    • Vascular compromise (hypotension, weak thready pulse, confusion, tachycardia)

Anaphylactic shock:

  • Provide reassurance, keep them calm
  • Ensure an adequate airway
  • Intubate if the patient can’t maintain an airway
  • Apply EKG pads to monitor
  • High flow O2 by non-rebreather
  • Start an IV, large bore cannula, normal saline or Lactated Ringers, macro drip, BP < 90 run it wide open
  • Administer epinephrine .3-.5 mg SQ, or IM with an Epi-Pen Bronchodilators may be used for stridor or wheezing
  • Transport priority patients

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