Case Study (Feb. 10th, 2023)

🚨👉 You are dispatched to a female patient complaining of shortness of breath, you arrive on scene to find your patient sitting in the car sitting up right with obvious stridor.

Upon further assessment you find urticaria and her skin is warm to touch.
She is able to answer your questions in 1 to 2 words between breaths.

She says she’s allergic to alder smoke, which she thinks she was exposed to at a restaurant 20 minutes ago.

Here are her vitals
👉 Skin Flush, warm
👉 LOC Alert but fatigued
👉 Eyes PEARRL
👉 Resps 28 increased effort
👉 Pulse 134 Sinus Tachycardia
👉 Temp Normal
👉 BP 82/58
👉 SPO2 86%

❓Is this an allergic reaction or anaphylactic?
❓What is your first line treatment for this patient?
❓You have a 30-minute transport, what other treatments may be beneficial to this patient?

Geoff is going live to break this down with members and on Facebook Live at 11AM MST (10PST, 1EST)

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[espygaming]

This is anaphlaxis. Multiple systems involved, Ariway due to the stridor and signs of imminent airway closer, Hypotension mean distributive shock, and uticharia/hives. First line is IM epi 1:1, our protocols allow up to 0.5mg but most I have seen call for standard 0.3mg. Additionally albuterol will be very helpful for this patient causing broncho dilation helping with the broncho spasms and airway and likely improving SpO2 (although Epi will be most benificial.) additionally once those treatments have been covered Benadryl will be usefull for the hives an uticharia. Keep a very close eye on the airway and if Epi does not improve this patient be prepared to intubate as waiting too long and losing the airway due to swelling would be detrimental.

[Jonas-Savimbi-]

Anaphylaxis, treat with HF o2, adrenaline, ventolin and antihistamines. Secure IV and give fluids until blood pressure is restored. Off to hospital

[trevormolloy]

Anaphylaxis. 0.3mg Epi, 50mg Diphenhydramine, 10mg Dexamethasone, ETCO2, O2, titrate fluid bolus, consider advanced airway

[jenniferbohnet-stgermain]

Ativan immediately. That's what happens to me and I have acute panic disorder. However my bpm and blood pressure spike. My father in law was stung to death by wasps, and even though he administered an epi as soon as he felt the first sting, he was gone in under a minute from anaphylaxis. She seems to be breathing well but to me it resembles a panic attack. Or a withdrawal maybe from alcohol?