Allergies

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Allergies

  1. 1. Chapter Allergies Sixteen
  2. 2. Chapter <ul><li>How to identify a patient experiencing an allergic reaction </li></ul><ul><li>Differences between a mild allergic reaction and anaphylaxis </li></ul><ul><li>How to treat the patient experiencing an allergic reaction </li></ul><ul><li>Who should be assisted with an epinephrine auto-injector </li></ul>CORE CONCEPTS Sixteen
  3. 3. Allergic Reaction An exaggerated reaction by the body’s immune system to any substance Anaphylaxis A life-threatening allergic reaction that causes shock (hypoperfusion) and airway swelling K EY TERMS
  4. 4. Insect Stings Foods Medications Plants Common Causes of Allergic Reactions
  5. 5. Skin (Continued) Signs and Symptoms <ul><li>Itching </li></ul><ul><li>Hives </li></ul><ul><li>Flushing </li></ul><ul><li>Warm, tingling feeling </li></ul><ul><li>Swelling (especially face, neck, hands, feet, tongue) </li></ul>
  6. 6. <ul><li>Tightness in throat/chest </li></ul><ul><li>Cough </li></ul><ul><li>Rapid, labored, noisy breathing </li></ul><ul><li>Hoarseness </li></ul><ul><li>Stridor and wheezing </li></ul>Respiratory Signs and Symptoms (Continued)
  7. 7. <ul><li>Increased heart rate </li></ul><ul><li>Low blood pressure </li></ul>Cardiac (Continued) Signs and Symptoms
  8. 8. <ul><li>Itchy, watery eyes and </li></ul>Generalized Findings runny nose <ul><li>Headache </li></ul><ul><li>Sense of impending </li></ul>doom (Continued) Signs and Symptoms
  9. 9. <ul><li>Decreasing mental status </li></ul><ul><li>Signs and symptoms of shock </li></ul>(hypoperfusion) or respiratory distress Signs and Symptoms
  10. 10. Patient ASSESSMENT Allergic Reactions Signs and Symptoms <ul><li>Initial assessment </li></ul><ul><li>Focused history and physical exam </li></ul><ul><li>Baseline vital signs and SAMPLE </li></ul>history (Continued)
  11. 11. Patient ASSESSMENT Allergic Reactions Signs and Symptoms <ul><li>What is patient allergic to? </li></ul><ul><li>What was patient exposed to? </li></ul><ul><li>How was the patient exposed? </li></ul><ul><li>What signs and symptoms does </li></ul>patient have? (Continued)
  12. 12. Patient ASSESSMENT Allergic Reactions Signs and Symptoms <ul><li>How have the signs and symptoms </li></ul>progressed? <ul><li>What interventions has patient </li></ul>received?
  13. 13. Obtain SAMPLE history. Take vital signs.
  14. 14. Apply high- concentration oxygen. If the patient meets criteria, assist in patient’s own epi-pen® administration.
  15. 15. Patient CARE Allergic Reactions Emergency Care Steps <ul><li>Reassess in 2 minutes. </li></ul><ul><li>Record reassessment findings. </li></ul><ul><li>If patient does not have epinephrine </li></ul>auto-injector, transport immediately. (Continued)
  16. 16. Patient CARE Allergic Reactions Emergency Care Steps <ul><li>Epinephrine is needed if patient: </li></ul><ul><li>Has come in contact with something that caused an allergic reaction in </li></ul>the past. (Continued)
  17. 17. Patient CARE Allergic Reactions Emergency Care Steps <ul><li>Epinephrine is needed if patient: </li></ul><ul><li>Shows signs and symptoms of </li></ul><ul><li>Complains of respiratory distress. </li></ul>shock (hypoperfusion) (Continued) <ul><li>Sometimes patient exhibits BOTH. </li></ul>OR
  18. 18. Patient CARE Allergic Reactions Emergency Care Steps <ul><li>Epinephrine is needed if patient: </li></ul><ul><li>Has a prescribed </li></ul>epinephrine auto-injector. (Continued)
  19. 19. Patient CARE Allergic Reactions Emergency Care Steps <ul><li>When the patient does not have respiratory distress or shock (hypoperfusion): </li></ul><ul><li>Continue with focused </li></ul><ul><li>Do not give epinephrine. </li></ul>assessment.
  20. 20. A IRWAY MANAGEMENT IN ALLERGIC REACTIONS
  21. 21. Note The patient may need aggressive airway management immediately, or very soon, because of swelling in the airway or respiratory compromise.
  22. 22. <ul><li>Patent shows signs of </li></ul>Indications epinephrine to patient. <ul><li>Medical direction </li></ul>authorizes epinephrine. Epinephrine Auto-Injector allergic reaction. <ul><li>Physician has prescribed </li></ul>
  23. 23. NONE, when used in life-threatening situations Contraindications Epinephrine
  24. 24. <ul><li>Auto-injector </li></ul>Medication Form Epinephrine
  25. 25. <ul><li>Adult </li></ul>Dosage <ul><li>Child </li></ul>One auto-injector One pediatric auto-injector Epinephrine
  26. 26. <ul><li>Injector prescribed for </li></ul>Administration this patient? <ul><li>Expiration date past? </li></ul><ul><li>Liquid cloudy </li></ul>or discolored? Epinephrine
  27. 27. If medical direction authorizes epi, remove safety cap. Place injector against patient’s mid-thigh, push and hold for 10 seconds.
  28. 28. Dispose of injector and record administration.
  29. 29. Epinephrine auto-injectors use needles to administer epinephrine. Injectable drugs are not commonly used at the EMT-B level. This truly life-saving drug is an exception. There are two important points to stress to a new EMT-B: After the auto-injector is placed against the patient’s thigh, it must be held in place to allow the medication to be injected. Simply pressing and immediately removing the device will be ineffective. After the device is used, it must be considered a contaminated sharp and treated accordingly: disposed of in a sharps container! P RECEPTOR P EARL
  30. 30. Actions <ul><li>Dilates bronchioles </li></ul><ul><li>Constricts blood vessels </li></ul>Epinephrine
  31. 31. <ul><li>Increased heart rate </li></ul><ul><li>Pallor and dizziness </li></ul><ul><li>Chest pain </li></ul><ul><li>Headache, excitability, and anxiety </li></ul><ul><li>Nausea and vomiting </li></ul>Side Effects Epinephrine
  32. 32. <ul><li>Transport. </li></ul><ul><li>Continue focused </li></ul>Reassessment Strategies assessment of airway, breathing, and circulation. Epinephrine
  33. 33. If patient’s condition WORSENS: Reassessment Strategies <ul><li>Consult medical direction </li></ul>about another dose. <ul><li>Treat for shock. </li></ul><ul><li>Be prepared to use </li></ul>CPR/AED. Epinephrine
  34. 34. Reassessment Strategies If patient’s condition IMPROVES: <ul><li>Continue oxygen. </li></ul><ul><li>Treat for shock (hypoperfusion). </li></ul>Epinephrine
  35. 35. 1. Explain how to identify a patient experiencing an allergic reaction. 2. What are the differences between a mild allergic reaction and anaphylaxis? 3. How is an allergic reaction treated? 4. When and how should the EMT-B assist a patient with an epinephrine auto-injector? R EVIEW QUESTIONS

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