Anaphylaxis is a severe allergic reaction that affects multiple body systems. It is uncommon but not rare, with new cases arising at rates of 8.4 to 21 per 100,000 people per year. Common triggers include foods, insect stings, and medications. Symptoms involve the skin, gastrointestinal tract, brain, lungs, heart, and can potentially lead to death from airway obstruction or shock. Prompt treatment with epinephrine and fluids is critical. Patients are observed for potentially recurring symptoms after initial treatment. Long-term management focuses on identifying and avoiding triggers, training to recognize symptoms, and avoiding complicating medications.
Anaphylaxis is a severe allergic reaction that can be life-threatening. The document discusses the pathophysiology of anaphylaxis including the role of basophils and mast cells in releasing inflammatory mediators like histamine. Signs and symptoms involve multiple organ systems like the skin, respiratory and cardiovascular systems. Management involves adrenaline injection, oxygen, fluids and monitoring for biphasic reactions.
ANAPHYLACTIC REACTIONS DUE TO VACCINATIONS IN PAEDIATRIC PATIENTSKanmani Srinivasan
This document discusses anaphylactic reactions to vaccines in paediatric patients. It defines anaphylaxis as a severe allergic reaction that can affect multiple body systems like the skin, respiratory tract, gastrointestinal tract and cardiovascular system. Common triggers of anaphylaxis include vaccines, foods and medications. The pathophysiology involves activation of mast cells and basophils leading to release of inflammatory mediators. Diagnosis is based on involvement of two or more body systems within hours of exposure to a known allergen. Treatment involves epinephrine and antihistamines. Components of vaccines like gelatin, egg and yeast are known causes of allergic reactions. The document provides guidelines for managing suspected adverse vaccine reactions.
The document discusses common medical emergencies that may be encountered in a dental office, including fainting, hyperventilation, asthma attacks, seizures, diabetes complications, chest pain, allergic reactions, choking, and cardiac arrest, and it provides information on prevention, signs and symptoms, and management of these conditions. Examples of management techniques covered include positioning patients, providing oxygen, glucose administration, abdominal thrusts, and performing cardiopulmonary resuscitation.
This document provides information on anaphylaxis including its definition, clinical criteria, causes, pathophysiology, clinical features, diagnosis, differential diagnosis, and management. Anaphylaxis is defined as a serious allergic reaction that is rapid in onset and can cause death. It is caused by exposure to an allergen in sensitized individuals and involves the release of mediators from mast cells and basophils like histamine. Symptoms may include skin issues, low blood pressure, respiratory distress, and gastrointestinal symptoms. Epinephrine is the first line treatment to reverse its effects.
This document provides information on medical emergencies that can occur in dental practice settings. It discusses the importance of recognizing at-risk patients and conducting thorough medical histories. It also outlines the primary survey process for assessing airway, breathing, circulation, disability, and exposure during a medical emergency. Finally, it provides details on responding to specific emergency situations like syncope, angina, myocardial infarction, seizures, hypoglycemia, asthma, foreign body obstruction, anaphylaxis, hyperventilation, and adrenal insufficiency.
Anaaphylactic and septic shock by danish rizviDanish00rizvi
This document discusses anaphylactic and septic shock. It defines anaphylaxis as a serious allergic reaction that causes symptoms like low blood pressure, rash, swelling of the throat or tongue. Common triggers include foods, medications, insect bites and stings. Septic shock is a type of distributive shock caused by infection that results in organ dysfunction due to inadequate blood flow. It has a high mortality rate and can be caused by infections like pneumonia or appendicitis. Diagnosis involves blood cultures, imaging and labs to check for organ damage.
Emergency,Poisoning, Immunization and ImmunosuppresionHome Alone
This document outlines learning objectives and content related to emergency drugs, poisoning management, immunization, and immunosuppression for nursing students. It defines key terms, describes common drugs used in emergencies like oxygen, saline, dextrose, epinephrine, and more. It also covers poisoning antidotes, vaccine types and schedules, and classes of immunosuppressive drugs. The document explains the nurse's role in administering these medications.
This document provides information on medical emergencies that may occur during dental procedures. It discusses the incidence of medical emergencies during dentistry, types of emergencies such as altered consciousness, cardiovascular, allergic reactions and respiratory issues. It also covers prevention, preparation and management of various emergencies like vasodepressor syncope, shock, anaphylaxis, hypertension, asthma, hyperventilation and airway obstruction. Management strategies for emergencies related to diabetes are also discussed.
Anaphylaxis is a severe allergic reaction that can be life-threatening. The document discusses the pathophysiology of anaphylaxis including the role of basophils and mast cells in releasing inflammatory mediators like histamine. Signs and symptoms involve multiple organ systems like the skin, respiratory and cardiovascular systems. Management involves adrenaline injection, oxygen, fluids and monitoring for biphasic reactions.
ANAPHYLACTIC REACTIONS DUE TO VACCINATIONS IN PAEDIATRIC PATIENTSKanmani Srinivasan
This document discusses anaphylactic reactions to vaccines in paediatric patients. It defines anaphylaxis as a severe allergic reaction that can affect multiple body systems like the skin, respiratory tract, gastrointestinal tract and cardiovascular system. Common triggers of anaphylaxis include vaccines, foods and medications. The pathophysiology involves activation of mast cells and basophils leading to release of inflammatory mediators. Diagnosis is based on involvement of two or more body systems within hours of exposure to a known allergen. Treatment involves epinephrine and antihistamines. Components of vaccines like gelatin, egg and yeast are known causes of allergic reactions. The document provides guidelines for managing suspected adverse vaccine reactions.
The document discusses common medical emergencies that may be encountered in a dental office, including fainting, hyperventilation, asthma attacks, seizures, diabetes complications, chest pain, allergic reactions, choking, and cardiac arrest, and it provides information on prevention, signs and symptoms, and management of these conditions. Examples of management techniques covered include positioning patients, providing oxygen, glucose administration, abdominal thrusts, and performing cardiopulmonary resuscitation.
This document provides information on anaphylaxis including its definition, clinical criteria, causes, pathophysiology, clinical features, diagnosis, differential diagnosis, and management. Anaphylaxis is defined as a serious allergic reaction that is rapid in onset and can cause death. It is caused by exposure to an allergen in sensitized individuals and involves the release of mediators from mast cells and basophils like histamine. Symptoms may include skin issues, low blood pressure, respiratory distress, and gastrointestinal symptoms. Epinephrine is the first line treatment to reverse its effects.
This document provides information on medical emergencies that can occur in dental practice settings. It discusses the importance of recognizing at-risk patients and conducting thorough medical histories. It also outlines the primary survey process for assessing airway, breathing, circulation, disability, and exposure during a medical emergency. Finally, it provides details on responding to specific emergency situations like syncope, angina, myocardial infarction, seizures, hypoglycemia, asthma, foreign body obstruction, anaphylaxis, hyperventilation, and adrenal insufficiency.
Anaaphylactic and septic shock by danish rizviDanish00rizvi
This document discusses anaphylactic and septic shock. It defines anaphylaxis as a serious allergic reaction that causes symptoms like low blood pressure, rash, swelling of the throat or tongue. Common triggers include foods, medications, insect bites and stings. Septic shock is a type of distributive shock caused by infection that results in organ dysfunction due to inadequate blood flow. It has a high mortality rate and can be caused by infections like pneumonia or appendicitis. Diagnosis involves blood cultures, imaging and labs to check for organ damage.
Emergency,Poisoning, Immunization and ImmunosuppresionHome Alone
This document outlines learning objectives and content related to emergency drugs, poisoning management, immunization, and immunosuppression for nursing students. It defines key terms, describes common drugs used in emergencies like oxygen, saline, dextrose, epinephrine, and more. It also covers poisoning antidotes, vaccine types and schedules, and classes of immunosuppressive drugs. The document explains the nurse's role in administering these medications.
This document provides information on medical emergencies that may occur during dental procedures. It discusses the incidence of medical emergencies during dentistry, types of emergencies such as altered consciousness, cardiovascular, allergic reactions and respiratory issues. It also covers prevention, preparation and management of various emergencies like vasodepressor syncope, shock, anaphylaxis, hypertension, asthma, hyperventilation and airway obstruction. Management strategies for emergencies related to diabetes are also discussed.
Anaphylactic shock is a severe allergic reaction that can occur rapidly after exposure to an allergen like bee venom or peanuts. It causes a drop in blood pressure and airway constriction due to chemicals released by the immune system. Symptoms include a weak pulse, rash, nausea and vomiting. Common triggers are foods, medications, insect venom and latex. Anaphylactic reactions require immediate epinephrine treatment in the emergency room to prevent unconsciousness or death.
This document discusses several common paediatric medical emergencies and their management, including cardiac arrest, cardiac tamponade, drowning, respiratory failure, altered sensorium, shock, haemorrhage, foreign body aspiration, poisoning, and road traffic accidents. For each condition, the etiology, clinical features, diagnosis, and emergency treatment are outlined. Emphasis is placed on maintaining airway patency, administering oxygen, controlling bleeding, relieving cardiac compression, and providing supportive care until definitive treatment can be given.
1. Urticaria and angioedema can be caused by allergic triggers like foods, drugs, infections, insect bites, or physical factors. Chronic urticaria lasts longer than 6 weeks.
2. Chronic urticaria is difficult to determine the cause of and may last for years. Physical urticarias are triggered by environmental stimuli and are often resistant to corticosteroids.
3. Angioedema causes swelling in the deep layers of the skin and tissues. It can be caused by allergic, pseudoallergic, or nonallergic mechanisms. Treatment depends on the mechanism but may include antihistamines, corticosteroids, or epinephrine to prevent air
Anaphylaxis is a serious allergic reaction that is rapid in onset and can cause death. It involves multiple organ systems and its symptoms can include skin issues, respiratory distress, gastrointestinal symptoms and low blood pressure. It is most often triggered by foods, medications or insect stings. Diagnosis is clinical based on symptoms appearing shortly after exposure to a potential trigger. Treatment involves epinephrine, oxygen, fluids and monitoring vital signs. Patients are observed for potential biphasic reactions after initial treatment and provided anaphylaxis action plans and epinephrine autoinjectors upon discharge.
Chapter 16: Medical Emergencies in a Dental OfficeHeatherSeghi
The document discusses several common medical emergencies that may occur in a dental office, including syncope, asthma, orthostatic hypertension, allergic reactions, anaphylaxis, hyperventilation, seizures, and diabetic emergencies like hypoglycemia and hyperglycemia. It provides details on symptoms, signs, and recommended treatments for each condition to safely manage a patient's care and when to contact emergency services.
Hyperventilation is a respiratory condition caused by excessive deep breathing and can occur due to dental anxiety. Symptoms include dizziness, numbness, muscle cramps and palpitations. To manage an episode, stop dental treatment, have the patient lie down and breathe into a paper bag to increase carbon dioxide levels and resolve alkalosis. Reassurance is also important while monitoring vital signs until symptoms subside. Parenteral anxiolytics may rarely be needed for severe cases unresponsive to other measures.
Here are some key emergency medications to have available:
- Epinephrine 1:1000 for anaphylaxis or cardiac arrest
- Aspirin for cardiac events
- Diphenhydramine for allergic reactions
- Flumazenil for benzodiazepine overdose
- Dextrose solutions and oral glucose for hypoglycemia
- Glucagon for hypoglycemia if unable to take oral glucose
- Nitroglycerin for chest pain
Having these basic emergency medications can help manage common medical emergencies until EMS arrives.
ATAXIA IN CHILDREN -CAUSES, MANAGEMENT, INVESTIGATIONS, TYPES, COMMONEST ATAXIA IN CHILDREN IN DETAIL, HOW WILL YOU FIND OUT THE CAUSE FOR ATAXIA IN CHILDREN FLOWCHART, DEFINITION, TREATMENT
The document discusses various medical and dental emergencies that may be encountered in dental practice, including syncope, airway obstruction, anaphylaxis, local anesthetic toxicity, asthma attacks, chest pain, hemorrhage, and seizures. It provides details on the signs and symptoms, management, and treatment of each condition. It also covers dental complications such as aspiration, allergic reactions, and sodium hypochlorite accidents, as well as considerations for patients with pacemakers or ICDs.
Anaphylaxis is a serious allergic reaction that can cause death. It involves multiple organ systems and symptoms often include skin issues like hives, respiratory issues like wheezing, and gastrointestinal issues like vomiting. Diagnosis is clinical based on symptoms. Prompt treatment with epinephrine injection is critical as delayed treatment can contribute to fatalities. Other treatments like IV fluids and antihistamines are also used. Proper diagnosis distinguishes it from other conditions that can mimic its symptoms.
This document discusses various hypoventilation disorders including obstructive and restrictive types. It covers topics like upper vs lower airway obstruction, patterns of hypoventilation, obstructive lung diseases like asthma, chronic bronchitis and emphysema. It also discusses tests to evaluate lung function and restrictive vs obstructive patterns. Central sleep apnea and exercise induced bronchoconstriction are also summarized.
Anaphylaxis Management: Problems with the Current Paradigm and the need for ...Michael Langan, M.D.
Michael Langan, MD
Geriatrician, MGH Senior Health
September 10, 2012
Epi-Port (cartridge housing, portable, fashionable, easy to use)
Epi-Pod (cartridge, removable, replaceable)
A new drug delivery system for treatment of anaphylactic shock
Twist, Turn, Push (TTP)
From concept to patent to market
1:30P.M.-2:30P.M.
Fox Hill Village Auditorium
Sponsored by the MGH Wellness Center
*************************
This document provides information on allergic rhinitis (AR), including its pathophysiology, classification, clinical presentation, diagnosis, and management. Some key points:
- AR results from an IgE-mediated inflammatory response in the nasal mucosa triggered by allergens. It causes symptoms like sneezing, rhinorrhea, and nasal congestion.
- It affects 10-20% of the population and is classified based on duration (intermittent vs persistent) and severity (mild, moderate, severe).
- A family history of allergies or asthma increases risk. Patients often have concurrent conditions like asthma, conjunctivitis.
- Treatment involves avoidance of triggers,
This document provides an overview of epilepsy, including its history, definitions, classification, signs and symptoms, diagnosis, and management. Some key points:
- Epilepsy affects nearly 40 million people globally, with India contributing nearly 1/3 of cases.
- It is characterized by recurrent seizures caused by abnormal neuronal activity in the brain.
- Seizures can be localized or generalized. Common types include tonic-clonic seizures.
- Diagnosis involves a medical history and examination, as well as tests like EEG, CT, or MRI.
- Treatment includes anti-seizure medications, emergency care during seizures, and potentially surgery for refractory cases.
Anaphylaxis is a severe, life-threatening allergic reaction that occurs rapidly after exposure to an allergen like peanuts or bee stings. It involves an antibody-mediated release of chemicals from the immune system that can cause shock, low blood pressure, airway narrowing, and breathing difficulties. Common causes include foods, medications, insect stings, latex, and other allergens. Immediate treatment involves epinephrine, oxygen, fluids, and positioning the patient to maintain airway patency.
Anaphylaxis is a serious allergic reaction that can affect multiple organ systems and be life-threatening. Common causes include foods, medications, insect stings, and latex. Symptoms may include low blood pressure, difficulty breathing, and skin issues like hives or swelling. Treatment depends on severity but may involve epinephrine, antihistamines, corticosteroids, IV fluids, and monitoring for several hours. Prevention involves strict avoidance of known allergens and carrying emergency medication like epinephrine.
Septicemia is a serious bloodstream infection caused when bacteria from another infection spread through the bloodstream. Common sources are respiratory, skin, gastrointestinal, or urinary infections. Symptoms can include fever
This document discusses asthma, including its causes, symptoms, classifications, pathophysiology, management, and related topics. It begins by defining allergy and hypersensitivity. It then discusses delayed-reaction allergy and allergic reactions like anaphylaxis. The document covers asthma prevalence globally and regionally. It examines asthma in children and precipitating factors. Signs and symptoms are outlined. The pathophysiology of asthma is explained in detail. Nutrition factors like vitamins, fish oil, and quercetin are discussed. Current therapies for asthma management are also summarized.
Syncope, hypotension, hypoglycemia, seizures, respiratory emergencies, and cardiovascular emergencies are some of the most common medical emergencies that can occur during dental procedures. Prevention involves taking a thorough medical history and being vigilant for symptoms. It is important to be prepared by having basic life support equipment and being affiliated with definitive medical care. Management of unconsciousness or specific emergencies involves stabilizing the patient and treating the underlying cause.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Reimagining Your Library Space: How to Increase the Vibes in Your Library No ...Diana Rendina
Librarians are leading the way in creating future-ready citizens – now we need to update our spaces to match. In this session, attendees will get inspiration for transforming their library spaces. You’ll learn how to survey students and patrons, create a focus group, and use design thinking to brainstorm ideas for your space. We’ll discuss budget friendly ways to change your space as well as how to find funding. No matter where you’re at, you’ll find ideas for reimagining your space in this session.
Anaphylactic shock is a severe allergic reaction that can occur rapidly after exposure to an allergen like bee venom or peanuts. It causes a drop in blood pressure and airway constriction due to chemicals released by the immune system. Symptoms include a weak pulse, rash, nausea and vomiting. Common triggers are foods, medications, insect venom and latex. Anaphylactic reactions require immediate epinephrine treatment in the emergency room to prevent unconsciousness or death.
This document discusses several common paediatric medical emergencies and their management, including cardiac arrest, cardiac tamponade, drowning, respiratory failure, altered sensorium, shock, haemorrhage, foreign body aspiration, poisoning, and road traffic accidents. For each condition, the etiology, clinical features, diagnosis, and emergency treatment are outlined. Emphasis is placed on maintaining airway patency, administering oxygen, controlling bleeding, relieving cardiac compression, and providing supportive care until definitive treatment can be given.
1. Urticaria and angioedema can be caused by allergic triggers like foods, drugs, infections, insect bites, or physical factors. Chronic urticaria lasts longer than 6 weeks.
2. Chronic urticaria is difficult to determine the cause of and may last for years. Physical urticarias are triggered by environmental stimuli and are often resistant to corticosteroids.
3. Angioedema causes swelling in the deep layers of the skin and tissues. It can be caused by allergic, pseudoallergic, or nonallergic mechanisms. Treatment depends on the mechanism but may include antihistamines, corticosteroids, or epinephrine to prevent air
Anaphylaxis is a serious allergic reaction that is rapid in onset and can cause death. It involves multiple organ systems and its symptoms can include skin issues, respiratory distress, gastrointestinal symptoms and low blood pressure. It is most often triggered by foods, medications or insect stings. Diagnosis is clinical based on symptoms appearing shortly after exposure to a potential trigger. Treatment involves epinephrine, oxygen, fluids and monitoring vital signs. Patients are observed for potential biphasic reactions after initial treatment and provided anaphylaxis action plans and epinephrine autoinjectors upon discharge.
Chapter 16: Medical Emergencies in a Dental OfficeHeatherSeghi
The document discusses several common medical emergencies that may occur in a dental office, including syncope, asthma, orthostatic hypertension, allergic reactions, anaphylaxis, hyperventilation, seizures, and diabetic emergencies like hypoglycemia and hyperglycemia. It provides details on symptoms, signs, and recommended treatments for each condition to safely manage a patient's care and when to contact emergency services.
Hyperventilation is a respiratory condition caused by excessive deep breathing and can occur due to dental anxiety. Symptoms include dizziness, numbness, muscle cramps and palpitations. To manage an episode, stop dental treatment, have the patient lie down and breathe into a paper bag to increase carbon dioxide levels and resolve alkalosis. Reassurance is also important while monitoring vital signs until symptoms subside. Parenteral anxiolytics may rarely be needed for severe cases unresponsive to other measures.
Here are some key emergency medications to have available:
- Epinephrine 1:1000 for anaphylaxis or cardiac arrest
- Aspirin for cardiac events
- Diphenhydramine for allergic reactions
- Flumazenil for benzodiazepine overdose
- Dextrose solutions and oral glucose for hypoglycemia
- Glucagon for hypoglycemia if unable to take oral glucose
- Nitroglycerin for chest pain
Having these basic emergency medications can help manage common medical emergencies until EMS arrives.
ATAXIA IN CHILDREN -CAUSES, MANAGEMENT, INVESTIGATIONS, TYPES, COMMONEST ATAXIA IN CHILDREN IN DETAIL, HOW WILL YOU FIND OUT THE CAUSE FOR ATAXIA IN CHILDREN FLOWCHART, DEFINITION, TREATMENT
The document discusses various medical and dental emergencies that may be encountered in dental practice, including syncope, airway obstruction, anaphylaxis, local anesthetic toxicity, asthma attacks, chest pain, hemorrhage, and seizures. It provides details on the signs and symptoms, management, and treatment of each condition. It also covers dental complications such as aspiration, allergic reactions, and sodium hypochlorite accidents, as well as considerations for patients with pacemakers or ICDs.
Anaphylaxis is a serious allergic reaction that can cause death. It involves multiple organ systems and symptoms often include skin issues like hives, respiratory issues like wheezing, and gastrointestinal issues like vomiting. Diagnosis is clinical based on symptoms. Prompt treatment with epinephrine injection is critical as delayed treatment can contribute to fatalities. Other treatments like IV fluids and antihistamines are also used. Proper diagnosis distinguishes it from other conditions that can mimic its symptoms.
This document discusses various hypoventilation disorders including obstructive and restrictive types. It covers topics like upper vs lower airway obstruction, patterns of hypoventilation, obstructive lung diseases like asthma, chronic bronchitis and emphysema. It also discusses tests to evaluate lung function and restrictive vs obstructive patterns. Central sleep apnea and exercise induced bronchoconstriction are also summarized.
Anaphylaxis Management: Problems with the Current Paradigm and the need for ...Michael Langan, M.D.
Michael Langan, MD
Geriatrician, MGH Senior Health
September 10, 2012
Epi-Port (cartridge housing, portable, fashionable, easy to use)
Epi-Pod (cartridge, removable, replaceable)
A new drug delivery system for treatment of anaphylactic shock
Twist, Turn, Push (TTP)
From concept to patent to market
1:30P.M.-2:30P.M.
Fox Hill Village Auditorium
Sponsored by the MGH Wellness Center
*************************
This document provides information on allergic rhinitis (AR), including its pathophysiology, classification, clinical presentation, diagnosis, and management. Some key points:
- AR results from an IgE-mediated inflammatory response in the nasal mucosa triggered by allergens. It causes symptoms like sneezing, rhinorrhea, and nasal congestion.
- It affects 10-20% of the population and is classified based on duration (intermittent vs persistent) and severity (mild, moderate, severe).
- A family history of allergies or asthma increases risk. Patients often have concurrent conditions like asthma, conjunctivitis.
- Treatment involves avoidance of triggers,
This document provides an overview of epilepsy, including its history, definitions, classification, signs and symptoms, diagnosis, and management. Some key points:
- Epilepsy affects nearly 40 million people globally, with India contributing nearly 1/3 of cases.
- It is characterized by recurrent seizures caused by abnormal neuronal activity in the brain.
- Seizures can be localized or generalized. Common types include tonic-clonic seizures.
- Diagnosis involves a medical history and examination, as well as tests like EEG, CT, or MRI.
- Treatment includes anti-seizure medications, emergency care during seizures, and potentially surgery for refractory cases.
Anaphylaxis is a severe, life-threatening allergic reaction that occurs rapidly after exposure to an allergen like peanuts or bee stings. It involves an antibody-mediated release of chemicals from the immune system that can cause shock, low blood pressure, airway narrowing, and breathing difficulties. Common causes include foods, medications, insect stings, latex, and other allergens. Immediate treatment involves epinephrine, oxygen, fluids, and positioning the patient to maintain airway patency.
Anaphylaxis is a serious allergic reaction that can affect multiple organ systems and be life-threatening. Common causes include foods, medications, insect stings, and latex. Symptoms may include low blood pressure, difficulty breathing, and skin issues like hives or swelling. Treatment depends on severity but may involve epinephrine, antihistamines, corticosteroids, IV fluids, and monitoring for several hours. Prevention involves strict avoidance of known allergens and carrying emergency medication like epinephrine.
Septicemia is a serious bloodstream infection caused when bacteria from another infection spread through the bloodstream. Common sources are respiratory, skin, gastrointestinal, or urinary infections. Symptoms can include fever
This document discusses asthma, including its causes, symptoms, classifications, pathophysiology, management, and related topics. It begins by defining allergy and hypersensitivity. It then discusses delayed-reaction allergy and allergic reactions like anaphylaxis. The document covers asthma prevalence globally and regionally. It examines asthma in children and precipitating factors. Signs and symptoms are outlined. The pathophysiology of asthma is explained in detail. Nutrition factors like vitamins, fish oil, and quercetin are discussed. Current therapies for asthma management are also summarized.
Syncope, hypotension, hypoglycemia, seizures, respiratory emergencies, and cardiovascular emergencies are some of the most common medical emergencies that can occur during dental procedures. Prevention involves taking a thorough medical history and being vigilant for symptoms. It is important to be prepared by having basic life support equipment and being affiliated with definitive medical care. Management of unconsciousness or specific emergencies involves stabilizing the patient and treating the underlying cause.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Reimagining Your Library Space: How to Increase the Vibes in Your Library No ...Diana Rendina
Librarians are leading the way in creating future-ready citizens – now we need to update our spaces to match. In this session, attendees will get inspiration for transforming their library spaces. You’ll learn how to survey students and patrons, create a focus group, and use design thinking to brainstorm ideas for your space. We’ll discuss budget friendly ways to change your space as well as how to find funding. No matter where you’re at, you’ll find ideas for reimagining your space in this session.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Article: https://pecb.com/article
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2. Introduction
Anaphylaxis is a severe immediate-type
generalised hypersensitivity reaction
affecting multiple organ systems and
characterised at its most severe by
bronchospasm, upper airway angioedema
and/or hypotension.
It has also been defined simply as “a
serious allergic reaction that is rapid in
onset and may cause death”.
3. How common is anaphylaxis?
Anaphylaxis is uncommon but not rare, with new
cases arising at rates of between 8.4 and 21 per
100 000 patient-years.
An Australian survey of parent-reported allergy
and anaphylaxis found that 1 in 170 school
children had suffered at least one episode of
anaphylaxis.
Another Australian study showed that, inareas
where native Myrmecia ant species are
prevalent, 1 in 50 adults have experienced
anaphylaxis after stings from native Myrmecia
species (Box 1) or honeybees.
4. Deaths from anaphylaxis are uncommon,
estimated to occur at a rate of 1 per 3 million
population per year.
In areas where sting allergy is common, the
death rate may be higher than this. Hospital-
based studies suggest a death rate in the order
of 1 per 100–200 episodes of anaphylaxis
treated in an emergency department.
There is some evidence that the incidence of
food allergy and anaphylaxis — like that of
allergic rhinitis and atopic dermatitis —may be
increasing.
5. What causes anaphylaxis?
Food, insect venoms or medication trigger most cases of
anaphylaxis, with a variable proportion of patients
experiencing idiopathic anaphylaxis (in which extensive
evaluation fails to identify an underlying cause).
In emergency department studies, food allergy is the
commonest cause in children — responsible for about
80% of anaphylactic reactions in which the cause has
been identified — whereas, in adults, foods are
implicated in only 20%–30% of cases.
This difference is reflected in mortality statistics: the
median ages for lethal reactions to foods and to insect
venoms or medications are 22–24 years and 55–67
years, respectively.
6. Summation anaphylaxis
Cofactors are sometimes required before an
allergen will provoke a reaction. Factors
associated with increased risk of anaphylaxis
include intercurrent infection, concomitant
medication/foods (particularly α-blockers, β-
blockers, angiotensin-converting enzyme [ACE]
inhibitors, non-steroidal anti-inflammatory drugs
[NSAIDS], alcohol or spicy food), high ambient
temperatures and exercise.
7. So-called “summation anaphylaxis” may explain
intermittent anaphylaxis despite frequent
allergen exposure, and may account for some
cases in which a cause has not been established.
15 One of the most common cofactors,
predominantly affecting young adults, is physical
exercise. Some experience symptoms with
exercise alone; others do so only if allergenic
foods (most commonly wheat, celery, seafood,
nuts, fruit or vegetables) are ingested within a
few hours prior to exercise.
8. What happens in anaphylaxis?
Mast cell activation results in the release of many
mediators that include histamine, leukotrienes,
tumour necrosis factor and various cytokines.
The large numbers of mediators provide redundancy
and positive feedback mechanisms whereby other
effector cells are recruited to release more
mediators, perpetuating the allergic response.
This amplification and perpetuation, which has been
referred to as a “mast cell leukocyte cytokine
cascade”, underscores the importance of
physiological antagonism with adrenaline and fluid
resuscitation, rather than antagonism of a single
mediator such as histamine.
Mast cell leukocyte cytokine cascade
9. Pathophysiology
Anaphylactic mediators cause vasodilation, fluid
extravasation, smooth muscle contraction and
increased mucosal secretions.
Death may occur from hypoxaemia (due to
upper airway angioedema, bronchospasm and
mucus plugging) and/or shock (due to massive
vasodilation, fluid shift into the extravascular
space and depressed myocardial function).
10. While compensatory tachycardia in response to
hypotension is considered a characteristic
feature, sudden bradycardia with cardiovascular
collapse and cardiac arrest may occur before any
skin features become apparent.
The cause of this phenomenon is unclear, but it
is an important clinical feature to recognise in
order to avoid making an initial misdiagnosis of
a “panic attack” or “vasovagal reaction” in cases
where dyspnoea, nausea, anxiety, and
bradycardia may occur just before cardiovascular
collapse.
11. Causes of anaphylaxis
Common
Insect stings: most commonly honeybee,
Australian native ants, wasps
Foods: most commonly peanuts, tree
nuts, egg, seafood, cows milk, dairy
products, seeds
Medications: most commonly antibiotics,
non-steroidal anti-inflammatory drugs
Unidentified (no cause found)
13. Clinical features of anaphylaxis
Mucocutaneous
Rhinitis
Conjunctival erythema
and tearing
Flushing
Itch
Urticaria
Angioedema
Abdominal/pelvic
Nausea
Vomiting
Abdominal pain
Pelvic pain (described as
being “like uterine
contractions”)
Delayed vaginal discharge
Neurological
Vascular headache (typically
described as “throbbing”)
Dizziness
Collapse, with or without
unconsciousness
Confusion
Incontinence
Respiratory/chest
Dysphagia and stridor
due to upper airway
angioedema
Throat and/or chest
tightness
Dyspnoea
Cough
Wheeze†
Cyanosis
14. Cardiovascular
Palpitations
Tachycardia
Bradycardia (relative or absolute)
ECG changes (T and ST changes)
Hypotension (These features are associated with
Hypotension and hypoxia)
Cardiac arrest (These features are associated with
Hypotension and hypoxia)
15. Facial erythema and oedema, seconds before the
onset of severe anaphylaxis with hypotension
Flushing and oedema can be transient, subtle and easily overlooked. Sometimes the only clue
may be “normal” (warm, well perfused) skin in the setting of circulatory collapse, when pallor
and poor perfusion would be the norm. In cases of acute-onset bronchospasm or hypotension,
look carefully for these features and ask relatives or friends if they have noticed any changes.
(Reproduced with permission from the patient.)
16. Differential diagnosis
Tissue swelling
Idiopathic urticaria
Isolated angioedema*
Idiopathic
ACE inhibitor-induced
Acquired or hereditary C1
esterase inhibitor deficiency
Conditions mimicking upper
airway oedema
Dystonic reactions mimicking
symptoms of a swollen
tongue after taking
metoclopramide,
prochlorperazine or
antihistamines
Acute oesophageal reflux
(sudden onset of painful
throat “swelling”)
Flushing syndromes
Peptide-secreting tumours
(eg, carcinoid syndrome,
VIPomas†)
Alcohol-related
Medullary carcinoma of
thyroid
“Red man syndrome”
Neurological syndromes
Epileptic seizure
Stroke
Other causes of collapse
Vasovagal episodes
Systemic inflammatory
response syndrome
Shock (septic, cardiogenic,
haemorrhagic)
18. Acute management
Place the patient in the supine position (or left
lateral position for vomiting patients)
Give intramuscular adrenaline
Resuscitate with intravenous saline (20mL/ kg
body weight, repeated up to a total of 50mL/kg
over the first half hour)
Support the airway and ventilation
Give supplementary oxygen
Cornerstones
19. Intramuscular 1 : 1000 (1 mg/mL) adrenaline at
a dose of 0.01 mg/kg (0.01mL/kg) body weight
up to a maximum dose of 0.5mg (0.5 mL)
injected into the lateral thigh (vastus lateralis)
has the advantage that it can be given without
delay, is absorbed more reliably than injections
into other locations or subcutaneously, is
anecdotally effective in most cases when given
early, and avoids the potentially lethal effects of
large intravenous bolus injections.
21. Intravenous adrenaline
If resuscitation using intramuscular adrenaline
and volume expansion with intravenous saline is
ineffective, an infusion of intravenous adrenaline
may be required, but this should be done only
by experienced hands.
Intravenous boluses of adrenaline are potentially
dangerous and should not be used unless
cardiac arrest is imminent.
An infusion protocol derived from this study has
been published elsewhere.
22. Management of persistent airway tract
obstruction and/or hypotension
Persistent bronchospasm may respond to
treatment with additional bronchodilators. If
intubation is required, continuous puffs of
salbutamol through an aerosol port directly into
the ventilation circuit may help to “break” severe
bronchospasm.
Persistent stridor may respond to continuous
nebulised adrenaline (5 mg in 5mL [ie, five 1mg
ampoules]) in addition to parenteral adrenaline.
Surgical airway intervention (cricothyrotomy)
may be required.
23. Persistent hypotension may be due to either
profound vasodilation or cardiac failure.
Anecdotally, vasodilation may respond to
vasopressors such as metaraminol or
vasopressin.26-28 In patients who have pre-
existing heart failure or are taking β-blockers, a
phosphodiesterase inhibitor such as glucagon
may be tried.
24. Ancillary medications
Medications such as antihistamines, H2 receptor
antagonists, corticosteroids and antileukotrienes
have no proven impact on the immediate and
dangerous effects of anaphylaxis, although they
may ameliorate mild allergic reactions confined
to the skin.
The only registered antihistamine for parenteral
use in Australia, promethazine, can worsen
vasodilation and hypotension, and its use is not
advised.
25. Until human research clarifies the potential risks
and benefits of antihistamines, it is prudent to
restrict antihistamine use to oral, selective, non-
drowsiness-inducing antihistamines, with or
without oral or injectable corticosteroids, for the
symptomatic relief of mild skin symptoms.
Based on their use in treating asthma,
corticosteroids are commonly given to reduce
the risk of biphasic anaphylaxis (see below),
although there is currently no evidence to
support their effectiveness for this purpose.
26. Investigation
Anaphylaxis remains a largely clinical diagnosis.
Serum mast cell tryptase concentration can be
determined, but this is an insensitive biomarker
for anaphylaxis, although serial measurements
(eg, on arrival, 1 hour later and before
discharge) may improve sensitivity and
specificity.
An elevated tryptase level may be a useful clue
when the diagnosis is uncertain, but a normal
result does not exclude anaphylaxis.
27. Observation
The time course of anaphylaxis can be classified
as “uniphasic”, “protracted” or “biphasic”.33
Although most reactions respond rapidly to
treatment and do not recur (uniphasic
reactions), an observation period is
recommended.
This is because, in some patients, symptoms
may fail to improve or may worsen as the effect
of adrenaline wears off (protracted anaphylaxis)
or may return after early resolution (biphasic
reaction).
28. No clinical feature consistently identifies patients
at risk of a biphasic reaction. Expert consensus
is that a reasonable length of observation after
symptom resolution is 4–6 hours in most
patients, with more prolonged observation in
those with severe or refractory symptoms and
those with reactive airway disease, as most
fatalities associated with anaphylaxis occur in
these patients.
Poorly controlled asthma is the main risk factor
for death in children. Age over 35 years and
previous severe reactions are the main risk
factors for hypotension and death in adults.
29. Investigation
In-vitro testing for allergen-specific IgE (using a radioallergosorbent
test [RAST] or ImmunoCAP [Phadia AB, Uppsala, Sweden]) is a
useful initial screening test for a variety of allergens. In-vitro testing
has limitations because the test lacks sensitivity and is limited by
the range of allergens available and the ability to claim Medicare
rebates for only four allergens at a time.
Skin prick testing, to assess sensitisation to food, and skin prick
testing (or sometimes intradermal testing), to assess allergy to
medications or insect venom, are more sensitive than in-vitro
testing.
As these carry a small risk of inducing anaphylaxis, they should only
be carried out in an environment in which resources for treating
anaphylaxis are available.
Measurement of total IgE and in-vitro testing using food mixes
frequently provide misleading or irrelevant results and should not be
requested.
30. There is currently no test to confirm tick bite allergy. Skin testing for
jack jumper ant allergy is not yet available outside the Royal Hobart
Hospital in Tasmania, although an in-vitro test is available from
SouthPath Laboratories in South Australia (this detects only 80% of
cases, and, while the subject of ongoing research, there is no
validated test to detect allergy to related ant species).
Some drug reactions (eg, to NSAIDS, radiographic contrast agents)
are independent of IgE, and there are numerous difficulties in
assessing some cases of antibiotic allergy.
To establish a diagnosis in cases in which the causative agent is in
doubt, challenge testing under controlled conditions may sometimes
be required, although a negative challenge test does not always
exclude the diagnosis.
There is no scientific validity for “alternative” therapies such as
cytotoxic or Vega testing, hair analysis and kinesiology, and their
use should be discouraged.
31. Long-term management
Specialist assessment.
Identification and avoidance of triggers and
cofactors, if possible. Common triggers of
anaphylaxis include food, stinging insects and
medication. Exercise, alcohol consumption and
taking NSAIDS are common cofactors.
Avoidance of medications that may complicate
management.
Training patients to recognise early warning
symptoms and to carry self-injectable adrenaline
(EpiPen) (after being trained in its use).
Provision of a written anaphylaxis action plan.
32. Evidence-based practice tips
Recommended acute management of a patient
with anaphylaxis is to place the patient in a
supine position and give adrenaline and
intravenous volume resuscitation (Level IV).
Intramuscular injection into the lateral thigh
(vastus lateralis) is preferred to injections into
arm or deltoid muscles or subcutaneously,
because of better absorption (Level III-1).
33. A controlled intravenous infusion of adrenaline is
a safe and effective management for
anaphylaxis (Level III-3).
A reasonable length of observation after
symptom resolution is 4–6 hours in most
patients, with more prolonged observation
recommended in patients with severe or
refractory symptoms (Level IV).
Venom immunotherapy prevents anaphylaxis to
insect stings and significantly improves quality of
life compared with carrying injectable adrenaline
(EpiPen) alone (Level II).
34. Case scenario
A 63-year-old man experienced sudden cardiovascular collapse at
02:00 in his home. This had been preceded by urticaria and a desire
to open his bowels. He was hypotensive, but responded to
treatment by paramedics (two 0.5mg doses of intramuscular
adrenaline into the lateral thigh, 5 minutes apart, and rapid
intravenous infusion of 2 L saline).
Earlier that evening, he had eaten a buffet meal consisting of bread,
various meats, vegetables, salads, sauces and alcohol, had been
dancing, and had taken ibuprofen for a headache before retiring to
bed at midnight. Concurrent medical problems included ischaemic
heart disease (treated daily with a β-blocker).
The patient was observed in the emergency department for 24
hours. There were no ECG changes, and there was no melaena or
rise in troponin level. His serum mast cell tryptase level was later
reported as 25 μg/L on arrival in the emergency department, falling
to 15 μg/L at the time of discharge, confirming the diagnosis of
anaphylaxis.
35. Management
Allergy testing showed no convincing evidence of food
hypersensitivity. The diagnostic possibilities of food or drug
hypersensitivity were considered, with or without involvement of
cofactors like alcohol, exercise and consumption of an NSAID.
The long interval between exercise and onset of a reaction was
considered to make exercise an unlikely cofactor. In-hospital
graded challenge with ibuprofen was negative. A provisional
diagnosis of idiopathic anaphylaxis was made, although it was
not possible to completely exclude an unidentified food allergen
or summation anaphylaxis (eg, unidentified food allergen ±NSAID
±exercise).
The initial difficulties in resuscitation, requiring two doses of
adrenaline and fluid resuscitation, were considered partially
attributable to β-blockade. After discussions with his cardiologist,
it was concluded that the patient could be safely given an
alternative cardiac medication and that the risk from untreated
anaphylaxis outweighed the theoretical risk of adrenaline
triggering myocardial ischaemia.
The patient was advised to carry and use injectable adrenaline
(EpiPen) in an emergency, and to document the circumstances in
any future reactions to assist in identifying an avoidable trigger.
36. The grey “locking” cap is first
removed. This enables the
device, so that, when the
opposite (black) end is pressed
against the lateral thigh, the
needle is activated and the
adrenaline injected.
The correct point of injection is the
outer thigh. The needle is designed to
penetrate thick clothing. A common
error is to press the grey end against
the thigh while pressing the thumb
onto the black tip, thus injecting the
adrenaline into the thumb. To prevent
this, we advise patients to always grip
the device as shown.