Anaphylaxis, Emergency Medicine

Sean-Xavier Neath Reviewed 06/2017
 


Basics

Description

  • An acute, widely distributed form of shock that occurs within minutes of exposure to antigen in a sensitized individual

  • ∼500–1,000 deaths are attributed annually in the US to anaphyla...

Diagnosis

Signs and Symptoms

  • Symptoms begin within seconds to minutes after contact with an offending antigen.

  • Anaphylactic reactions almost always involve the skin or mucous membranes. >90% of patie...

Treatment

Pre-Hospital

  • IV access, O2, cardiac and pulse oximetry monitoring

  • Early intubation based on the initial progression of disease and response to treatment:

    • Laryngeal edema and spasm can progress ...

Follow-Up

Disposition

Admission Criteria

  • Intubated patients or patients in respiratory distress should be admitted to an intensive care unit setting.

  • A monitored inpatient bed may be necessary for the pa...

Pearls and Pitfalls

  • Failure to consider anaphylaxis early in presentation can lead to devastating hemodynamic compromise and airway collapse.

  • Epinephrine given early is the most important intervention.

  • ...

Additional Reading

  • Barach  EM, Nowak  RM, Lee  TG, et al. Epinephrine for the treatment of anaphylactic shock. JAMA.  1984;251:2118–2122.

  • Lieberman  P, Kemp  SF, Oppenheimer  J, et al. The diagnos...

Codes

ICD9

  • 989.5 Toxic effect of venom

  • 995.0 Other anaphylactic reaction

  • 995.60 Anaphylactic reaction due to unspecified food

ICD10

  • T63.91XA Toxic effect of contact w unsp venomous animal, acc, init

  • T78.00X...

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