DEALING WITH ALLERGIC AND ANAPHYLAXIS SHOCK
The incidence of true anaphylaxis is rare. Most allergic reactions can be managed with over-the-counter anti-histamines. Epinephrine has been given mistakenly to patients for mild allergic reactions, hyperventilation syndrome and panic attacks.
Treatment for Allergic Reactions and Anaphylaxis
- Remove the allergen or the patient from the offending environment.
- Administer oral antihistamines (e.g. diphenhydramine 50mg PO every 4-6 hours).
- If patient shows signs and symptoms of anaphylaxis (Swollen face, lips and tongue; difficulty swallowing; systemic hives; respiratory distress; inability to speak in more than one or two word clusters; signs and symptoms of shock) administer epinephrine .3ml/1:1000 SQ or IM.
- If reaction reoccurs or the epinephrine is ineffective, continue to administer epinephrine.
Evacuation Guidelines for Allergic Reactions and Anaphylaxis
- Any patient who continues to show respiratory compromise or signs and symptoms of shock after treatment with epinephrine and antihistamines.
- Any patient who has received epinephrine. Continue to provide anti-histamines during evacuation.
Emergency Medical Technician-Basic: National Standard Curriculum Module 4 Medical/Behavioral Emergencies and Obstetrics/Gynecology. 22 June 1995. National Highway Traffic Safety Administration United States Department of Transportation. 2 Dec 2004. <www.nhtsa.dot.gov/people/injury/ems/pub/emtbnsc.pd>
“Position Statement 26:The Use of Epinephrine in the Treatment of Anaphylaxis.” American Academy of Allergy Asthma & Immunology. 28 Dec. 2004. <http://www.aaaai.org/media/resources/position_statements/ps26.stm>;
Schimelpfenig, Tod and Linda Lindsey. “Poisons, Stings, and Bites.” Wilderness First Aid 3rd ed. Mechanicsburg, Pennsylvania: Stackpole Books, 2000. Chapter 11.
Specific Protocols for Wilderness EMS Allergic Reactions. Version 1.2 May 19, 1994. The Wilderness Emergency Medical Services Institute. 2 Dec. 2004. <http://www.wemsi.org/specific.html>;
The Merck Manual 16th Edition. Rathaway, New Jersey: Merck & Co., Inc., 1992.
Tilton, Buck. “Allergic Reactions and Anaphylaxis.” Wilderness First Responder 2nd ed. Guilford, Connecticut: The Globe Pequot Press, 2004. Chapter 28.
Wilderness Field Protocols Protocol 1 Anaphylaxis. 2001. Wilderness Medical Associates. 2 Dec. 2004 < http://www.wildmed.com/field_protocols/anaphylaxis_protocol05.01.html#top>;
Wilkerson, James A. “Allergies.” Medicine for Mountaineering 5th ed. Seattle, Washington: The Mountaineers Books, 2001. Chapter 20.
Tags: First Aid,