How do you assess for anaphylaxis?
See also Emergency drug and fluid calculator Show
Key points
BackgroundMost reactions occur within 30 minutes of exposure to a trigger but can occur up to 4 hours later
Newer monoclonal antibody therapies may produce delayed anaphylactic reactions and rebound symptoms that occur more than 12 hours after the initial reaction NB: a cause is not identified in 20% of cases AssessmentIdentify risk factors for fatal anaphylaxis
Anaphylaxis is a clinical diagnosis made in the setting of the acute onset of either:
A detailed history of pre-hospital events is vital to confirm anaphylaxis and its associated trigger(s)
ManagementInvestigationsAnaphylaxis is a clinical diagnosis. A serum tryptase has no role in acute management of anaphylaxis. It should only be ordered after consultation with a paediatric allergy specialist in special circumstances. Treatment
The following doses of adrenaline may be used
Example autoinjectors
Other treatments to consider
Observation and admission All children with anaphylaxis should be observed for at least 4 hours in a supervised setting with facilities to manage deterioration
The acute care setting should provide resources, education and follow up options to the family including:
EpiPen® / EpiPen Jnr® / Anapen® are available on PBS for all children with a history of acute anaphylaxis. See Guidelines for
the prescription of an EpiPen for more information
Peripheral IV adrenaline infusionThis should only be done in consultation with a senior staff member. Avoid high infusion rates for more than two hours as it may cause fluid overload
Consider consultation with local paediatric team when
Consider transfer when
NB: Also consider consultation with paediatric allergy/immunology team Consider discharge whenSee Observation and Admission section above For emergency advice and paediatric or neonatal ICU transfers, see Retrieval Services Parent information sheetsAllergic and anaphylactic reactions Additional notesIn Victoria it is a requirement to notify all cases of anaphylaxis presenting to hospital, to the Department of Health and Human Services (this does not include cases arising in hospital) Where the suspected cause is the consumption of a packaged food, notifications are required to be made immediately (within 24 hours of diagnosis) by telephone (1300 651 160, which is staffed 24 hours a day, seven days a week) Where the suspected cause is anything other than packaged food, notifications are required to be made within five days of initial diagnosis of anaphylaxis and electronically via the online form through the department's website Last updated January 2021 How do you assess patient for anaphylaxis?Patient assessment should also include recording of blood pressure and respiratory rate and oxygen saturation levels (if a pulse oximeter is available) and when documenting the incident, it is useful to record what occurred immediately prior to the reaction to try and determine a cause, and also time to resolution, if ...
What are the 3 criteria for anaphylaxis?Anaphylaxis – Indicated by any one of the following signs:
Difficulty talking or hoarse voice. Wheeze or persistent cough - unlike the cough in asthma, the onset of coughing during anaphylaxis is usually sudden. Persistent dizziness or collapse.
What are the 4 signs of anaphylaxis?Symptoms of anaphylaxis. feeling lightheaded or faint.. breathing difficulties – such as fast, shallow breathing.. wheezing.. a fast heartbeat.. clammy skin.. confusion and anxiety.. collapsing or losing consciousness.. What should the nurse assess for a patient having an allergic reaction?The nurse must assess all patients for allergies or previous reactions to antigens. Assess patient's knowledge. The nurse must also assess the patient's understanding of previous reactions and steps taken by the patient and the family to prevent further exposure to antigens.
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