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CHAPTER 20 Allergic Reactions Assessment of Allergic Reactions Allergic reaction: An exaggerated immune response to a substance that comes into contact with the body. A severe allergic reaction is called anaphylaxis or an anaphylactic reaction. Allergen: A substance that commonly causes allergic reactions, such as insect bites or stings, foods, plants, and medications. Causes of Allergic Reactions Common Allergens Insect bites Foods Plants Meds Insect stings Always check for a medical alert bracelet or necklace carried by people who have severe allergic reactions. Signs and Symptoms of Allergic Reactions Allergic reactions can result in a variety of signs and symptoms. Signs & Symptoms of Allergic Reactions Increased heart rate Decreased blood pressure Coughing, stridor, wheezing or noisy respirations Rapid, labored breathing Tightness in the throat, hoarseness Hives (urticaria) Itchy, red or flushed skin Allergic Reactions continued Tingling in face, mouth, chest, hands and feet Body swelling and rash Itchy, watery eyes Patient may feel uncomfortable and display odd behavior Headache Respiratory distress and hypoperfusion are the most serious complications of allergic reactions... …when these signs and symptoms are present, immediate intervention may be needed. Remember that the earliest sign of hypoperfusion is a change in the mental status of the patient. Emergency Care for Patients with Allergic Reactions Airway Interventions Patients with mild allergic reactions should be transported and observed for changes in status. Serious Signs or Symptoms History Focused and brief Previous reactions and severity Medications available for reaction, tablets or epinephrine autoinjector Physical examination Baseline vital signs Signs of allergic reaction Airway Management Treat the patient with severe respiratory distress secondary to allergic reaction aggressively... …high flow O2 and airway management techniques, including BVM, may be necessary. Reassessing the airway of a patient with an allergic reaction is a TOP PRIORITY! Administration of Medication Epinephrine: A medication used to dilate the bronchioles, prevent tissue swelling, constrict the blood vessels and increase the ability of the heart to pump blood. Autoinjector: A device that administers a preset dose of medication in a safe manner, by way of intramuscular self-injection. The Epinephrine Autoinjector Criteria for Epinephrine Autoinjector Assessment reveals a patient with a severe allergic reaction Respiratory compromise and/or hypoperfusion Medication has been prescribed for this patient by a physician Medical direction authorizes use for this patient Expiration date current There are NO CONTRAINDICATIONS to epinephrine in a lifethreatening emergency! Use of the Autoinjector Obtain authorization. Use of the Autoinjector continued Remove the safety cap. Use of the Autoinjector continued Place tip at 90-degree angle against thigh. Common Epinephrine Side Effects Increased heart rate and blood pressure Pale skin Dizziness Chest pain Headache Continue to reassess the patient every 5 minutes after epinephrine injection! RAPID TRANSPORT IS ESSENTIAL! Some patients may also carry an antihistamine, known as Benadryl, for mild allergic reactions. SUMMARY Assessment of Allergic Reactions Emergency Care for Patients with Allergic Reactions
