anaphylaxis cne.pptx NURSING 4 YR BSC NURS

NURSING EDUCATION

1. ANAPHYLAXIS

2. INTRODUCTION Anaphylaxis is a severe, life-threatening allergic reaction occurring within seconds or minutes of exposure to some allergents to, such as peanuts or bee stings. It causes the immune system to release a flood of chemicals that can cause shock, blood pressure drops suddenly and the airways narrow and can cause breathing difficulty .

3. DEFINITION Anaphylaxis is a clinical response to an immediate (Type 1 hypersensitivity ) immunologic reaction between a specific antigen and an antibody. The reaction results from a rapid release of IgE – mediated chemicals, which can induce a severe life threatening reaction.

4. CAUSES FOODS Peanuts, walnuts, cashews, shell fish (eg : shrimp, lobster,crab ),fish ,milk ,egg,soy,wheat,beans.

5. MEDICATIONS Antibiotics especially penicillin and sulfa antibiotics, allopurinol, radiocontrast agents, anesthetic agents, vaccines, hormones ( insulin, vasopressin, adrenocorticotropic hormone), aspirin, NSAIDs .

6. INSECT STINGS Bee venom, antivenom, cockroach calyx, dust mites, wasps, hornets, mold spores, animal hair

7. LATEX medical and non medical products containing latex OTHER PHARMACEUTICAL OR BIOLOGIC AGENTS Animal serums, (tetanus antitoxin, snake venom antitoxin, rabies antitoxin), antigens used in skin testing

8. IMMEDIATE CLINICAL FEATURES Hives and itching Peripheral tingling and sensation of warmth

9. Pale or flushed skin Nasal congestion, cough and wheezing Abdominal cramping, nausea, vomiting diarrhea in case of food allergy

10. Laryngospasm Dizziness Weak pulse , hypotension

11. IMMEDIATE MANAGEMENT History collection regarding the causes of reaction Monitor pulse, oxygen saturation and blood pressure Monitor ECG for any cardiac abnormality Administration of IV fluids (normal saline 1-2 L ) Oxygen administration

12. Loosen tight clothing and cover the person with a blanket. D on't give the person anything to drink. If there's vomiting or bleeding from the mouth, turn the person to the side to prevent choking. Placement of the patient in the supine position with the lower extremities elevated, If there are no signs of breathing, coughing or movement, begin CPR Intubation should be performed on an emergency basis if stridor or respiratory distress due to upper airway compromise is present.

13. EMERGENCY MEDICATIONS Epinephrine Hydrocortisone Albuterol Diphenhydramine

14. EPINEPHRINE Normal adult d ose : 50 to 100 mcg (equal to 0.05 to 0.1 mg) Route : IV / IM Mechanism of action: It decreases mediator release from mast cells, prevents or reverses obstruction to airflow in the upper and lower respiratory tracts, and prevents or reverses cardiovascular collapse .

15. HYDROCORTISONE Normal adult dose : 20 to 240 milligrams (mg) Route :Intravenous / Intramuscular Mechanism of action :  Inhibits accumulation of inflammatory cells at inflammation sites, phagocytosis, lysosomal enzyme release and synthesis, and release of mediators of inflammation .

16. ALBUTEROL Normal adult dose :1 puff Route :Inhalation Mechanism of action: Acts on beta 2 adrenergic receptors , including bronchial smooth muscles relaxations and inhibiting immediate hypersensitivity mediator release , particularly from mast cells

17. DIPHENHYDRAMINE Normal adult dose : 10 – 50 mg Route : IV/IM Mechanism of action:  A cts as an inverse agonist at the H1 receptor, thereby reversing the effects of histamine on capillaries, reducing allergic reaction symptoms.