Allergic Reactions // Envenomation

Allergic Reaction

An immune system response brought on by a trigger

Allergies

A substance (can be a chemical, food item, etc) that triggers an immune response

Urticaria

Allergic reaction sign characterized by the eruption of pale red, elevated patches called wheals or hives

Mild Allergic Reaction S/S

Hives (urticaria), localized itching, runny nose, tearing eyes

Moderate Allergic Reaction S/S

Mild S/S + affecting breathing such as a cough, wheeze

Severe Allergic Reaction S/S

Mild S/S + Moderat S/S + circulatory compromise evident by lowering blood pressure

Bee stings/Wasp

Watch for any S/S of an allergic reaction, remove the stinger with a credit card or something similar across the skin. Avoid using tweezers

-You can give ice for comfort

Fire Ants

Watch for any S/S of an allergic reaction

-Most common insect reaction in US

-Wash area with soap and water and provide supportive care

Black Widow Spider

Venom is a neurotoxin, it causes suppression of the CNS.

-Patient will experience abdominal cramping after about an hour.

-Has a red hourglass on its belly, found in all 50 states

-Clean with soap and water provide supportive care until transferred to ED

Brown Recluse Spider

Most common in the southwest region, also known as a fiddle back

-Little pain when bitten

-Local tissue necrosis, causes the surrounding tissue to die

-White wheel around bite

-Takes about 2 days for necrosis to get to bone, if not caught early you must cut out skin to prevent further damage

-Supportive care, cold compresses and sterile dressings

Scorpion

Only one kind of fatal to healthy people in U.S, the sculptured scorpion.

-Localized pain

-Wash with soap and water, ice for pain

-Generally produces pain but little no local swelling

Tick Bites

Long term complications rather than an imminent emergency.

-Rocky Mountain Spotted Fever: About 40 deaths per year, develops slowly over 5-7 days. After about 2-3 days small pink spots on ankles and wrists, patient will feel sick like the flu.

-Lyme Disease: Red dot at site of bite. Feel sick like the flu. After about 4-6 weeks cardiac problems present. Last stage presents with arthritis symptoms` over next several years if not diagnosed.

Removing a tick

Grass part of tech closest to the skin, the head, and apply steady upward pressure. Do not remove text by using nail polish, petroleum jelly, or heat

-Can use Vaseline to suffocate

Plant Poisoning

2nd most common reported poisoning next to ingestion of cleaning substances

-Wash the area while wearing cleaning gloves to minimize risk of you getting poisoned

-Wash with soap non-stop

-Usually not lethal

Snake Bites

Vipers, rattlesnakes, and coral snakes are the ones to look out for

-Vipers: digestive toxins, two punctures

-Coral: CNS depressants, chew in soft places like in between fingers

-NO ice on snakes, can cause increased tissue necrosis. Ice can be used once the toxin has been neutralized. Do not use constricting bands, do not suck out poison

Snake Bite Treatment

If lower bitten area, splint the area. 20% of all bites do not envenomate.

Man-of-War

Jellyfish, when human. gets stung tentacles remain embedded in tissue

-Was with soap and water, can use ice for pain

-Stinging, red-brown wheals. Remove tentacles, rinse with sea water

Rabbies

Racoons, bats, skunks, dogs, squirrels, etc can carry this

-Acute viral infection of the CNS, can take months before becomes active and kills patient. Once symptoms are seen, high mortality rate

-Incubation 9 days to 7 year

-S/S: Low fever, headache, loss of appetite, AMS, leads to death if untreated

-Wash bite with soap and water. dry dressings to pull fluid from bite

Anaphylactic Shock

Another name for a severe allergic reaction

What are the possible routes that trigger an allergic reaction?

IV, Inhalation, Ingestion, Topical

Is it better to give EPI early or late?

Late because most patients only carry 2 EPI pens on them, and they only "hold back" the reaction ~20 minutes. Use only when needed so you can get to definitive care