30 min

Round 10 (Allergic Reaction) EM Clerkship

    • Médecine

CAUTION: THESE NOTES CONTAIN SPOILERS!!!







Case Introduction







A 45 year old female is exposed to peanut butter and shrimp pizza and begins to have an apparent allergic reaction…















Initial Vitals







* Temp 98.8* HR 130* RR 35* BP 70/40* O2 92%







Critical Actions







* Verbalize Airway Evaluation* Complete a FOCUSED History and Exam* Normal Saline Bolus* Epinephrine both IM and (subsequently) IV* Glucagon 1mg IV







Final Diagnosis







Refractory Anaphylaxis Due to Beta Blockers







Tips and Tricks







You still need to obtain a quick history and exam even if you know the diagnosis in the first few seconds of the case







Additional Reading







* Basic approach to anaphylaxis (EM Clerkship)* Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors. (PubMed)* Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers. (PubMed)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!







Case Introduction







A 45 year old female is exposed to peanut butter and shrimp pizza and begins to have an apparent allergic reaction…















Initial Vitals







* Temp 98.8* HR 130* RR 35* BP 70/40* O2 92%







Critical Actions







* Verbalize Airway Evaluation* Complete a FOCUSED History and Exam* Normal Saline Bolus* Epinephrine both IM and (subsequently) IV* Glucagon 1mg IV







Final Diagnosis







Refractory Anaphylaxis Due to Beta Blockers







Tips and Tricks







You still need to obtain a quick history and exam even if you know the diagnosis in the first few seconds of the case







Additional Reading







* Basic approach to anaphylaxis (EM Clerkship)* Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors. (PubMed)* Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers. (PubMed)

30 min

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