Respiratory Distress: Allergic Reaction/Anaphylaxis

1.

What are some signs of severe allergic reaction?

A.

Pharyngeal swelling
B.

Diffuse wheezing
C.

Loss of peripheral pulses
D.

Hypo-perfusion
E.

Stridor
F.

Dyspnea

Correct Answer(s)
A. Pharyngeal swelling
B. Diffuse wheezing
C. Loss of peripheral pulses
D. Hypo-perfusion
E. Stridor
F. Dyspnea

Explanation
These are all signs of a severe allergic reaction. Pharyngeal swelling refers to swelling in the throat, which can cause difficulty in breathing and swallowing. Diffuse wheezing is a high-pitched whistling sound that occurs when air flows through narrowed airways. Loss of peripheral pulses indicates poor blood circulation to the extremities. Hypo-perfusion refers to inadequate blood flow to the body's organs and tissues. Stridor is a harsh, vibrating sound that occurs during breathing and is caused by obstruction of the airway. Dyspnea is shortness of breath or difficulty in breathing. All of these signs together suggest a severe allergic reaction.

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2.

What are the BLS treatments that can be administered for a patient experiencing an allergic reaction?

A.

Epinephrine auto-injector (adult 0.3 mg) (pediatric 0.15 mg)
B.

Albuterol inhaler max of 4 puffs over 30 minutes
C.

Aspirin 325 mg
D.

Both A and B

Correct Answer
D. Both A and B

Explanation
Both A and B are the correct answer because both the epinephrine auto-injector and the albuterol inhaler are commonly used in BLS (Basic Life Support) treatments for patients experiencing an allergic reaction. The epinephrine auto-injector is used to quickly deliver a dose of epinephrine, which helps to reduce the severity of the allergic reaction. The albuterol inhaler is used to open up the airways and improve breathing. These treatments can be administered by trained individuals in emergency situations to provide immediate relief to the patient.

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3.

What are the ALS treatment for adult and pediatric patients experiencing a severe allergic reaction?

A.

Epi 1:1,000 0.01 mg/kg IM for a max single dose of 0.5 mg; may repeat every 5 mintutes for a total of 3 doses. Additional does require medical consultation.
B.

Epi 1:10,000 0.01 mcg/kg IM for a max single dose of 0.5 mcg; may repeat every 5 mintutes for a total of 3 doses. Additional does require medical consultation.
C.

Initiate IV LR fluid therapy 20 mL/kg; titrate to a systolic pressure of 100.
D.

Diphenhydramine 50 mg slow IV/IM; Pediatrics 1 mg/kg slow IV/IM/IO for a max of 50 mg. Additional doses require medical consultation.
E.

For adults, CPAP or Nebulizer mask with 2.5 mg of Albuterol and 500 mcg of Atrovent via nebulizer. One additional dose of Albuterol may be given if needed. For pediatric patients less than 1 year, 1.25 mg of Albuterol only. For pediatric patients 1-2 years old 1.25 mg of Albuterol and 250 mcg of Atrovent. Treat pediatric 2 years and above as an adult with Albuterol and Atrovent.
F.

Dopamine 2-20 mcg/kg/min

Correct Answer(s)
A. Epi 1:1,000 0.01 mg/kg IM for a max single dose of 0.5 mg; may repeat every 5 mintutes for a total of 3 doses. Additional does require medical consultation.
C. Initiate IV LR fluid therapy 20 mL/kg; titrate to a systolic pressure of 100.
D. Diphenhydramine 50 mg slow IV/IM; Pediatrics 1 mg/kg slow IV/IM/IO for a max of 50 mg. Additional doses require medical consultation.
E. For adults, CPAP or Nebulizer mask with 2.5 mg of Albuterol and 500 mcg of Atrovent via nebulizer. One additional dose of Albuterol may be given if needed. For pediatric patients less than 1 year, 1.25 mg of Albuterol only. For pediatric patients 1-2 years old 1.25 mg of Albuterol and 250 mcg of Atrovent. Treat pediatric 2 years and above as an adult with Albuterol and Atrovent.

Explanation
The correct answer includes a combination of treatments for adult and pediatric patients experiencing a severe allergic reaction. For both adults and pediatrics, Epi 1:1,000 is administered at a dose of 0.01 mg/kg IM, with a maximum single dose of 0.5 mg. This can be repeated every 5 minutes for a total of 3 doses. IV LR fluid therapy is initiated at a rate of 20 mL/kg and titrated to a systolic pressure of 100. Diphenhydramine is given at a dose of 50 mg slow IV/IM for adults and 1 mg/kg slow IV/IM/IO for pediatrics, with a maximum dose of 50 mg. For adults, a CPAP or Nebulizer mask with Albuterol and Atrovent is used, with the option of an additional dose of Albuterol if needed. Pediatrics are treated differently depending on age, with specific doses of Albuterol and Atrovent.

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4.

What is the adult and pediatric treatment for anaphylactic shock?

A.

Epi 1:1,000 0.01 mg/kg IM for a max single dose of 0.5 mg; may repeat every 5 mintutes for a total of 3 doses. Additional does require medical consultation.
B.

With medical consultation Epi 1:10,000 0.01 mg/kg slow IVP for a max of 1 mg
C.

Diphenhydramine 50 mg slow IVP/IM
D.

With medical consultation Epi 1:1,000 0.01 mg/kg slow IVP for a max of 1 mg

Correct Answer
B. With medical consultation Epi 1:10,000 0.01 mg/kg slow IVP for a max of 1 mg

Explanation
The adult and pediatric treatment for anaphylactic shock involves administering Epi 1:10,000 at a dosage of 0.01 mg/kg slowly through intravenous push (IVP) for a maximum dose of 1 mg. This treatment should be done with medical consultation. Epi 1:10,000 is a more dilute concentration of epinephrine compared to Epi 1:1,000, but it is preferred for intravenous administration. This dosage and administration route help to counteract the severe allergic reaction and stabilize the patient's condition. Additionally, Diphenhydramine 50 mg can be given slowly through IVP or intramuscular (IM) route as an additional treatment option.

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5.

What is the adult and pediatric treatment for a mild allergic reaction?

A.

Glucagon 1 mg
B.

With medical consultation, Diphenhydramine 25 mg slow IVP/IM or Epi 1:1,000 0.01 mg/kg IM for a max single dose of 0.5 mg
C.

Consider fluid bolus at 20 mL/kg; titrate to a systolic pressure of 100.
D.

All of the above

Correct Answer(s)
B. With medical consultation, Diphenhydramine 25 mg slow IVP/IM or Epi 1:1,000 0.01 mg/kg IM for a max single dose of 0.5 mg
C. Consider fluid bolus at 20 mL/kg; titrate to a systolic pressure of 100.

Explanation
The correct answer is "With medical consultation, Diphenhydramine 25 mg slow IVP/IM or Epi 1:1,000 0.01 mg/kg IM for a max single dose of 0.5 mg, Consider fluid bolus at 20 mL/kg; titrate to a systolic pressure of 100." This answer provides the appropriate treatment options for both adult and pediatric patients with a mild allergic reaction. It suggests the administration of Diphenhydramine or Epi, depending on the medical consultation, and also recommends considering a fluid bolus to maintain a systolic pressure of 100.

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