anaphylaxis (thing)

The summary and a few nitbits:

Anaphylaxis is a medical EMERGENCY.

In anaphylaxis, death occurs through respiratory arrest. Forget intubation or tracheostomy^*. The airway blockage is at the level of the bronchi below the larynx.

The first thing to do is yell for the ADRENALINE (epinephrine).

Then, in order:

1. lay the patient down and raise the feet
2. ensure the airway is free
3. monitor blood pressure
4. give adrenaline 1ml of 1 in 1000 intramuscularly or intravenously
5. give antihistamines and/or hydrocortisone
6. if hypotensive, give intravenous infusion of fluid (colloid better than crystalloid)
7. if still hypoxic, oxygen and/or assisted ventilation may be necessary (this is when you can consider the intubation or trachy)

^*There might be a place for intubation/tracheostomy if CPAP (continuous positive airway pressure) is available.