Anaphylactic_Death.ppt

Anaphylactic_Death.ppt

• 1.
  ANAPHYLACTIC DEATH Prepared By:Dr. Hira Batool
• 2.
  Anaphylaxis  Serious allergicreaction that is rapid in onset and may cause death  The rate of occurrence is increasing in industrialized countries  it can mimic many other conditions and is variable in its
• 3.
  Signs and symptoms Cutaneous symptoms, -90 % (flushing, itching, urticaria, and angioedema (including periorbital edema and conjunctival swelling)  Respiratory symptoms, -70 %, (nasal discharge, nasal congestion, change in voice
• 4.
  Diagnosis   TWO ORMORE OF THE FOLLOWING that occur rapidly after exposure to a likely ALLERGEN (min to hours)  Acute onset of an illness  (over minutes to several hours) involving the skin, mucosal tissue or both)
• 5.
  Acute management  Oxygen:Give 6 to 8 liters per minute via face mask, or up to 100 percent oxygen as needed  INTUBATION: Immediate intubation if evidence of impending airway obstruction from angioedema delay may lead to complete obstruction
• 6.
  Contd...  Rapid bolus: Treat signs of poor perfusion with rapid infusion of 20 mL /Kg  Re-evaluate and repeat fluid boluses (20 mL per kilogram) as needed  Monitor urine  Massive fluid shifts with severe loss of intravascular volume can occur output
• 7.
  Contd...  Albuterol: Forbronchospasm resistant to IM epinephrine, give albuterol 0.15 mg per kilogram (minimum dose: 2.5 mg) in 3 mL saline inhaled via nebulizer; repeat as needed  H1 antihistamine: Give diphenhydramine 1 to 2 mg per
• 8.
  Contd...  Give epinephrine0.01 mg per kilogram intramuscularly (maximum per dose: 0.5 mg), preferably in the mid- anterolateral thigh, can repeat every 3 to 5 minutes as needed.  If signs of poor perfusion are
• 9.
  Contd...  Patients mayrequire large amounts of IV crystalloid to maintain blood pressure  If response to epinephrine and saline is inadequate  Dopamine (5 to 20 micro grams per kilogram per minute) can be given as continuous infusion, titrated to effect and with constant hemodynamic monitoring
• 10.
  Treatment Errors  Failureor delay to administer epinephrine promptly due to over- reliance on antihistamines, albuterol, glucocorticoids.  Epinephrine should be administered as soon as possible once anaphylaxis is
• 11.
  Safe Approach  Seeksupport — Advise the patient  Allergen identification and avoidance  Follow-up with specialty care  Epinephrine for emergencies
• 12.
    Thank You:)  Any Question?