Allergic Reaction Cme SARAH
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Transcript of Allergic Reaction Cme SARAH
8/6/2019 Allergic Reaction Cme SARAH
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Presented by: Chris McAllister
Allergic Reaction Allergic Reaction
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Allergic Reaction, Definition
An immune system response to acertain substance that the body
mistakenly interprets as harmful.
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Allergic Reaction,
Anaphylaxis defined
A sudden, severe allergic reaction
that involves various areas of thebody simultaneously or causes
difficulty breathing and swelling of
the throat and tongue. In extreme
cases, it can cause death. This type
of reaction is sometimes called a
systemic, or general body, reaction
or allergic shock.
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Allergic ReactionAllergic reaction is the bodys response (hyper-
response) to antigens outside the body
The bodys allergic response is the ALLERGIC REACTION
ANTIGEN is what the body responds to. i.e., the bee sting. A substancethat is capable of causing the production of an antibody
ANTIBODY, also known as an immunoglobulin, is a large Y-shaped proteinused by the immune system to identify and neutralize foreign objects likebacteria and viruses
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Allergic Reaction, Antigen
An ANTIGEN enters the body by:� Injection
� Ingestion
� Inhalation
� Absorption
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Allergic Reaction
Antigens may be:
� Drugs
� Foods
� Insect Venoms
� Animal Serum
� Bacteria
� Mold
� Pets
� Incompatible blood types
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Allergic Reaction
The ANTIGEN induces ANTIBODY formation when the body deems theantigen as a threat.
The antigen binds with antibody as shown above. This is the less severeallergic reaction, and causes inflammatory response.
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Allergic reactions
� Allergic reactions vary in severity from
extremely mild to deadly
� A person may have an allergic reaction at to
anything at any age without history of allergic
reactions in past� People with history of allergic reaction may
have their own Epi pen or medical jewelry
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Allergic Reaction
Mild allergic reactions may cause the following:
� Coughing, sneezing, red, watery eyes and nasal congestion� Fever
� Uticaria (hives), or raised swellings on the skin that itch
� Itching (with or without visible changes in skin)
� Joint or muscle aches
� Redness of the skin or a rash
� Swelling of the tongue, eyelids, or face
� Worsening of Asthma or an asthma flare-up, which makes breathing
difficult
�
Anxiousness
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Allergic Reaction
Moderate/Severe reactions may
cause more severe cases of mildsymptoms, plus:
� Abdominal distress or cramping
� Chest tightness/ discomfort
�Difficulty swallowing
� Dizziness or light-headedness
� Unconsciousness
� Respiratory distress/arrest
(Type 1 allergic reactions)
� Wheezing/Stridor
� Palpitations
� Swelling of face, mouth, tongue
� Rapid onset severe symptoms
� Weakness
� Nausea, Vomiting, Diarrhea
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Allergic ReactionA TYPE 1 ALLERGIC REACTIONS
OCCUR WHEN ANTIBODIESATTACH THEMSELVES TO MAST
CELLS OR BASOPHYLLS.
� Once antibodies attach to MASTCELLS the white blood cells producean antibody specific to that antigen.This is called "sensitization."
�
Now that they are sensitized, thenext time the body comes in contactwith antigen the cells willdegranulate and release mediators,causing a cascade=
SEVERE ALLERGIC REACTION
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Allergic reaction
When the mast cell is activated� Histamine is released and heads for specific cell surface histamine
receptors, called H1-receptors; present on most cells in the body. Theiroccupation by histamine results in the symptoms of allergic disease.
� Histamine activates the enzyme phospholipase A, which in turn releasesarachidonic acid--a fatty acid--from the phospholipid membrane of the
mast cell. Leukotrienes are created� In addition to their constricting effect on bronchial muscle, the
leukotrienes also act on blood vessels, causing them to become leaky andresulting in the swelling of the skin. Leukotrienes are powerful chemoattractants, recruiting eosinophils and thus contributing to the ongoingallergic inflammation.
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Allergic Reaction
H1 Histamine receptors
cause:� Smooth muscle contraction
� Increased vascular
permiability/vasodialation
� Prostaglandin degranulation
(further dilation and lowers B/P,
Bronchoconstriction)
� Enhanced mucus production
� Pruritis (itching)
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Allergic Reaction
H2 receptors cause:
� Increased vascular permeability
� Gastric acid secretion
� Stimulation of suppressor
lymphocytes� Decreased PMN enzyme release
� Increased release of histamine
from Mast cells and Basophylls
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Allergic Reaction
And finally H3 receptors cause:
� Inhibition of central and peripheral nervous system neurotransmitter
release
�
Further histamine formation and release
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Allergic Reaction
LETS CUT THE MUMBOJUMBOá..
WHAT DOES THIS ALL MEAN FOR THE PATIENT?
WHAT DOES THIS ALL MEAN FOR EMS?
WHAT CAN WE DO FOR OUR PATIENT TOENSURE SURVIVAL?
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Allergic Reaction
RAPID INTERPRETATION OF PATIENT SIGNS AND
SYMPTOMS AND KNOWLEDGE OF LOCALCLARK COUNTY PROTOCOLS WILL ENSURE
SURVIVAL OF YOUR PATIENT
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Allergic Reaction
UNDERSTANDING WHAT IS HAPPENINGINSIDE YOUR PATIENTS BODY DURINGAN ALLERGIC REACTION WILL HELP YOUTO IDENTIFY THE PROBLEM AND TREAT EFFECTIVELY
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Allergic Reaction, THE BREAK DOWN
When an allergen enters the body turns into a mean militarymachine! The body wants:
To STOP the entry process
To DESTROY the enemy
To MINIMIZE exposure/damageTo expedite the REMOVAL of
the attack
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STOP ENTRY PROCESSSo why would the body
willingly bronchoconstrictand release chemicals thatcause breathing difficulty?
This is the bodys way of closing itsself off to pathogens it suspectsare out in the environment duringan attack.
Causes respiratory distress, stridor,airway obstruction
NO FURTHER INVASION!!!
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DESTROY THE ENEMY!
Antibodies detect and destroy substances that cause disease and sickness. Inallergic reactions, the antibody is called immunoglobulin E, or IgE
Mediators activate more white blood cell defenders.
Activated mast cells and basophils undergo a process called degranulation,during which they release histamine and other inflammatory chemicalmediators (Cytokines, interleukins, leukotreines, and prostaglandins)
THIS IS ALL TO SEEK OUT AND DESTROY THE INTRUDER!
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MINIMIZE EXPOSURE TIME
� Vasodialation-Decreased peripheral
resistance. Body does not want to pumpantigen throughout body. Causes peripheral
hypo perfusion, increased HR, hypotension.
� Increased tissue permeability and
leakage from vascular space- Dump
antigen out of circulation. Cause of
hypovolemic shock.
� Increased tissue permiability-
Breakdown of cells to leak out contents. Tissue
edema, uticaria, itching.
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REMOVAL OF ATTACK
� Spasms of GI tract- Causes diarrhea, nausea, vomiting and cramping.Flush/ rid body of antigen
� Spasm of Bladder- Causing urinary urgency/incontinence to flushbody
� H
yper production of mucus- Trap and remove antigen
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Allergic Reaction� OXYGEN-Oxygen is essential for cell metabolism, and in turn, tissue
oxygenation is essential for all normal physiological functions.
� BENADRYL-H1 receptor antagonist. Blocks the effect of histamine. Benadrylinhibits most responses of smooth muscle to histamine and acts as avasoconstrictor by inhibiting the vasodilator effects of histamine. The antagonismmay also produce anticholinergic effects, antiemetic effects, and significantsedative side-effects.
� ALBUTEROL- Short-acting 2-adrenergic receptor agonist used for the
relief of bronchospasm.
� EPINEPHRINE- Is a hormone and a neurotransmitter. It increases heartrate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system.
� NACL- Combats loss of blood pressure and circulation during Anaphylacticshock
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Allergic Reaction
MILD ALLERGIC REACTION:
� If patient treated with Benadryl pills at home, notehow many milligrams and time taken.
� Monitor A,B,C·s closely!!! Obtain thorough history of
allergic reactions in the past. IV/02.� If bee sting, remove bee stinger with credit card to
scrape off, try not to break inside patient·s skin.
� May require Benadryl 50 mg. IV/IM and possible
breathing treatment if wheezing present.
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Allergic Reaction� MODERATE ALLERGIC REACTION: Monitor A,B,CÙs closely!!!
� High flow 02 (be prepared to control airway)
� IV fluids if hypo perfusion (titrate to 90mm systolic)
� EKG monitor
� Benadryl 50 mg. IM or IV ADULT
� Benadryl 1 mg/kg IV/IM PEDIATRIC
� If Wheezing present, treat with Albuterol until improves
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Allergic ReactionSEVERE ALLERGIC REACTION/ANAPHYLAXIS:
ANGIOEDEMA/STRIDOR and/or SHOCK, TREAT SHOCK!
� A·s and B·s- Protect airway as needed, high flow 02, may needBVM. May need to use in-line nebulizer with BVM for Albuterol.
� C·s- 2 Large bore IV·s, treat NACL wide open. Titrate B/P
�
Cardiac monitor, Benadryl, and Albuterol as before� Epinephrine .5 mg 1:1,000 IM every 15 minutes per pt. condition
(max 1.5 mg)
� IF imminent circulatory collapse is likely treat Epinephrine .5 mg1:10,000 IV
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Allergic ReactionONE CONSIDERATION AT THE
TRACK IS ACTIVATING THERESPONSE OF A
TRANSPORTING AGENCY.
RESPIRATORY ARREST IS A
PARAMOUNT CONCERN IN
ALLERGIC REACTION!
ACTIVATE TRANSPORTING
AGENCY EARLY.
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Allergic Reaction
The hospital has more options to treat the patient with, including steroids,
mast cell stabilizers, compounds thought to impair eosinophil chemotaxis,
Anti-leukotrienes , immunotherapy, etc
Doctors frequently order test that may pinpoint what the patient is allergic to.
Skin tests, lab work, challenge testing, and patch testing are just a few of
the tests performed. Many people may never find what they had the
reaction to, but may be prescribed a life saving Epi-pen in case of another
reaction