Anaphylaxis is a type 1 hypersensitivity reaction that occurs suddenly following sensitization to an allergen, often after the third exposure. It is mediated by immunoglobulin E (IgE) antibodies binding to allergens and causing degranulation of mast cells and basophils, releasing inflammatory mediators like histamine. Common symptoms include urticaria, angioedema, stridor, shortness of breath, nausea, vomiting, and shock. Epinephrine administered via autoinjector like an EpiPen is the first-line treatment and should be administered immediately if anaphyl

1. Allergies and anaphylaxis
By Ben Green

2. Instructions
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3. Anaphylaxis
Basic science

4. Anaphylaxis
 Type 1 hypersensitivity reaction
 Sudden onset immunological reaction
 Following sensitisation to an allergen
 Often following the 3rd exposure
 Mediated by IgE

5. 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.

6. Recognising
anaphylaxis

7. Picture Quiz
a
The following slides list common symptoms
of anaphylaxis!
Select the tab that matches the picture in
order to advance!

8. Stridor/wheeze
Nausea/vomiting
AngioedemaShortness of breath
Cyanosis
ShockUrticaria
Common allergens

9. Stridor/wheeze
Nausea/vomiting
Shortness of breath
Cyanosis
ShockUrticaria
Common allergensAngioedema

10. Nausea/vomiting
Shortness of breath
Cyanosis
ShockUrticaria
Common allergensAngioedema
Stridor/wheeze

11. Stridor/wheeze
Nausea/vomiting
AngioedemaShortness of breath
Common allergens
ShockUrticaria
Cyanosis

12. Stridor/wheeze
Nausea/vomiting
AngioedemaShortness of breath
Common allergens
Shock
Cyanosis
Urticaria

13. Insects and stings

15. Insects and stings
Wasp stings
The wasp sting is easy to
insert, and easy to come out
 Delivers 2-15mcg venom
Alkaline
Treatment
 Remove sting
 Elevation
 Ice

16. Insects and stings
Bee stings
 The bee sting is barbed
and is harder to remove
 Delivers 50mcg venom
Formic/methanoic acid
Treatment
 Remove sting
 Elevation
 Ice

17. Match the insect to the ‘cure’

18. Match the insect to the ‘cure’

19. Bicarbonate for Bees

20. Match the insect to the ‘cure’

21. Vinegar for Vasps

22. 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!

30. Well done!
Having successfully treated your patient you
decide to review the anaphylaxis guidelines to
make sure your treatment was correct!

31. UK Resuscitation Council Guidelines

32. UK Resuscitation Council Guidelines

33. Autoinjectors

34. Anapens
 Deliver injection into outer thigh
 3 different pens (dose varies with colour)
 Delivers adrenaline
 Hold in place for 10s
 Massage for 10s

35. Epipens
Deliver injection into outer thigh
Delivers 0.3mg adrenaline
 Hold in place for 10s
 Massage for 10s
 See video

36. Adrenaline and
autoinjectors
True or false
Correctly answer a question to advance!

37. Adrenaline and autoinjectors
Adrenaline targets both alpha and beta
adrenergic receptors!
FalseTrue

38. Adrenaline and autoinjectors
You must remove clothing and expose the
skin before using the autoinjector!
True False

39. Adrenaline and autoinjectors
Adrenaline treats shock by causing
peripheral vasoconstriction!
FalseTrue

40. Scenarios
Split into pairs
1 member wait outside the room…
Scenario 1 Scenario 2

41. 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

42. Scenario 1
Information for first aiders...
The casualty is looking pale and clammy
Upon examination has a weak rapid pulse

43. Scenario 2
Information 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

44. Scenario 2
Information for first aiders...
You notice swelling around the patients
face and lips
You notice the patient looks very flushed