Resuscitation techniques in anaphylaxis

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Information about Resuscitation techniques in anaphylaxis
Health & Medicine

Published on October 13, 2014

Author: mex1877

Source: slideshare.net

Description

Third series for Resuscitation in difficult situations.

1. RESUSCITATION TECHNIQUES IN ANAPHYLAXIS B Y A N U G O M E M E K A M B B C H , M P H , M S C O C C M E D , I G C N E B O S H

2. WELCOME & INTRODUCTIONS  Logistics  Emergency exits  Restrooms 2

3. AGENDA  Introduction  What is Anaphylaxis  Causes of Anaphylaxis  Epidemiology  Management of Cardiac arrest in Anaphylaxis  Supportive Management for Anaphylaxis  Conclusion  References  Q&A 3

4. INTRODUCTION  Various difficult situations may arise that lead to cardiac arrest.  The skill of bystanders is paramount for outcome of survival.[1]  Resuscitation will need to be modified in these situations depending on their peculiarities and reversible causes.  Early recognition and proper management of Airway Breathing Circulation Disability and Exposure (ABCDE) is very important for survival.[2]  Image: ht tp: / /www.bygeorgejournal .ca/?p=3077 4

5. INTRODUCTION  This presentation is a review based on 2010 Guidelines by American Heart Association and European Resuscitation Council.  Prior Knowledge of current BLS/ACLS guidelines or resuscitation is assumed.  Image: http://en.wikipedia.org/wiki/Mast_cell 5

6. WHAT IS ANAPHYLAXIS?  A Multi-systemic life-threatening hypersensitivity reaction that may lead to cardiopulmonary collapse.[3,4]  Commonly misdiagnosed especially if it is not life-threatening.[3] 6  Image 1: http://jef f reyster lingmd.com/ tag/anaphylaxis /  Image 2: ht tp: / /www.pb-coaching.com/anaphylaxis-be-aware-of-symptoms -and-emergency - t reatment /

7. CAUSES OF ANAPHYLAXIS?  It is mostly idiopathic  but may arise from common triggers like :  - Food (especially in children)  - Drugs (especially in adults)  - Insect bites  - Latex etc.[3,4] 7  Image: ht tp: / /www. rushdenosteopath.co.uk/news/2012/02/anaphylact ic - shock-act -quickly/

8. EPIDEMIOLOGY  The annual frequency of episodes is 30 to 950 cases per 100,000persons[3,4]  There is a life time prevalence of 0.05 to 2%[3,4]  It accounts for 50 to 100 deaths annually in the United States.[3,4] 8  Image 1: ht tp: / /www.webmd.com/al lergies/anaphylaxis -13/sl ideshow-al lergy- t r iggers  Image 2: ht tp: / /en.wikipedia.org/wiki /Anaphylaxis

9. MANAGEMENT OF CARDIAC ARREST IN ANAPHYLAXIS  In the event of a cardio-respiratory arrest arising from anaphylaxis, normal BLS and ACLS guidelines are to be followed.[2,3,4]  There is need to monitor the following parameters for diagnosis and evaluation :  - Pulse  - Blood pressure  - ECG  - Arterial blood gases  - Elecrolytes  - Chest X-ray and  - Mast cell tryptrase [3,4] 9  Image 1: ht tp: / /www.bygeorgejournal .ca/?p=3077  Image 2: ht tp: / /medipptx.blogspot .com/2010_08_01_archive.html

10. MANAGEMENT OF CARDIAC ARREST IN ANAPHYLAXIS  Insert advanced airway early via  - intubation or  - cricothyroidotomy  This MUST be done quickly because of risk of soft tissue swelling  Ensure ventilation with Bag valve mask.  Administer Epinephrine(Adrenaline) parenteral:  - Intramuscular or  - Intravenous (To be given by experts only).[3,4] 10  Image 1: ht tp: / /en.wikipedia.org/wiki /Tracheal_intubat ion  Image 2: ht tp: / /www.mnn.com/heal th/ f i tness -wel l -being/stor ies/cardiac -ar rest - survival - improved-by- increased- resusci tat ion- t ime

11. MANAGEMENT OF CARDIAC ARREST IN ANAPHYLAXIS  CPR maybe prolonged in this case. [3,4]  Fluid resuscitation with isotonic crystalloids like normal saline is also important. [3,4]  Administer high concentration and high flow oxygen to the patient. [3,4]  Other vasoactive drugs and inotropes can also be utilized if they are non-responsive to epinephrine like:  - Vasopressin  - Noradrenaline etc. [3,4] 11  Image 1: ht tp: / /cache.dayl i fe.com/ imageserve/0avEbCp0A60EH/340x. jpg  Image 2: ht tp: / /www.gponl ine.com/managing-anaphylaxis-dur ing-emergency/ al lergic -disorders/anaphylaxis/ar t icle/1052048

12. SUPPORTIVE MANAGEMENT FOR ANAPHYLAXIS Other supportive management that may be beneficial includes :  use of Antihistamine H1 and H2 antagonists  IV Corticosteroids  Inhaled/IV Bronchodilators and  Extracorporeal support like Cardiopulmonary bypass[3,4] 12  Image 1: ht tp: / /www.medscape.com/ features/sl ideshow/acaai2012#6  Image 2: http://www.webmd.com/al lergies/anaphylaxis -13/sl ideshow-al lergy- t r iggers

13. CONCLUSION  Difficult situations may arise or lead to need for resuscitation.  Modifications and consideration of reversible factors, including importance of making early decisions to - initiate resuscitation - invite expert and - manage the patient accordingly is paramount to survival in these situations. 13  Image: ht tp: / /www.gponl ine.com/managing -anaphylaxis -dur ing-emergency/ al lergic -disorders/anaphylaxis/ar t icle/1052048

14. CONCLUSION  Mastery and awareness of the basic techniques and guidelines for BLS/ACLS by everyone is crucial to success in resuscitation in theses situations.  Get Trained to save lives. 14  Image: ht tp: / /en.wikipedia.org/wiki /Cardiopulmonary_resusci tat ion

15. REFERENCES  1. J.R Casal Codesido, y M.J. Vazquez Lima, 2007; Out-of Hospital Cardiopulmonary Resuscitation: Where are We now? Emergencias 2007;19:295-297.  2. Australian Resuscitation Council; New Zealand Resuscitation Council, 2011; Guideline 11.10 Resuscitation in Special Circumstances: 1-14  3. Jasmeet Soar et al,2010, European Resuscitation Council Guidelines for 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma,anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution; Elsevier Ireland Ltd, Resuscitation 81(2010)1400-1433, doi:10.1016/j.resuscitation.2010.08.015  4. Terry L. Vanden Hoek et al, 2010, Cardiac Arrest in Special Situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care; Circulation.2010:122:S829-S861; doi:10.1161/CIRCULATIONAHA.110.971069; Online ISSN:1524-4539 15

16. . 16  Image:http: / /handsonblog.org/2011/01/26/eight - t ips-for-wr i t ing- the-per fect - thank-you- note/

17. QUESTIONS 17  Image: ht tp: / /www.openbkautoloans.com/wp -content /uploads/2012/04/quest ion - and-answers-bad-credi t -car- f inancing. jpg

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