Allergies and Anaphylaxis Blended
Allergies and Anaphylaxis Overview
Anaphylaxis is a severe, potentially life-threatening allergic reaction.
It can occur rapidly after exposure to allergens.
Page 2: Respiratory Anatomy and Functions
Respiratory system shaped like an inverted tree.
Trachea acts as the trunk while alveoli act as the leaves.
Page 3: Upper and Lower Airway Structure
Upper Airway Components:
Nasal cavity
Nasopharynx
Oropharynx
Laryngopharynx
Larynx
Lower Airway Components:
Trachea
Primary bronchi (left and right)
Bronchioles
Vocal cords mark the boundary between the upper and lower airway.
Page 4: Airway vs. Breathing Problems
Ventilation:
Involves oxygen intake and CO2 elimination.
Breathing alterations can be complex and require:
Intact muscular and neurological control.
Conditions to consider include:
Asthma
Bronchitis
Pneumonia
Emphysema
Flail chest
Page 5: Asthma Emergency
Video resource available for visual learning on asthma emergencies.
Page 6: Muscles and Mechanics of Breathing
Patients with asthma often compensate for respiratory distress by:
Devoting more energy to maintain oxygen levels.
Failing to maintain this may lead to decompensation.
Patients may prefer sitting positions to ease breathing.
Page 7: Indicators of Degree of Distress
Signs of respiratory distress:
Work of breathing increases leading to muscle fatigue.
Physical signs include:
Chest-wall retractions
Soft tissue retractions
Nasal flaring
Tracheal tugging
Paradoxical movements
Pulsus paradoxus (blood pressure drops during inspiration).
Page 8: Assessing Breathing
Breathing assessment includes:
Rate and depth of breath.
Patterns of breathing (I:E ratio).
Abnormal respiratory noises can indicate serious conditions.
Page 9: Skin Color Assessment
Changes in skin color can provide early indicators of a patient's condition:
Cyanosis: Blue discoloration indicates lack of oxygen.
Pale Skin: May suggest other issues.
Page 10: Focused History Assessment
Important to ascertain:
Reason for seeking help.
History of chronic respiratory issues and past treatments.
Characteristics of dyspnea (onset, duration).
Position of comfort for breathing.
Page 11: History of the Problem
Collect information on:
Repeating respiratory conditions.
Attempts at any treatment.
Associated symptoms experienced.
Page 12: Data Collection Tools
Use a stethoscope for:
Auscultation of lung sounds (high vs. low pitch).
Note that lung conditions may present as asymmetrical.
Page 13: Breath Sounds Assessment
Sound transmission varies:
Better in fluid than air.
Adventitious breath sounds may indicate complications:
Continuous or discontinuous sounds.
No breath sounds are the most critical sign.
Page 14: Asthma Overview
Asthma is characterized by:
Inflammation in bronchiole airways.
Reversible narrowing of airways.
Acute attacks vary in duration.
Page 15: Bronchospasm Mechanism
Bronchospasm: Constriction of smooth muscle in the bronchi.
Can be triggered by allergens or irritants, leading to:
Wheezing sounds.
Page 16: Bronchial Inflammation
Underlying cause of asthma attacks,
Steroid treatments may be utilized in prehospital settings.
Page 17: Allergy Terminology
Definitions include:
Allergen: A substance that causes an allergic reaction.
Antibody (Immunoglobulin): A body protein that fights antigens.
Antigen: A substance that can induce an immune response.
Hypersensitivity: An exaggerated response to an allergen.
Anaphylaxis: Severe allergic reaction.
Page 18: Anaphylaxis Statistics & Risk Factors
Responsible for 500 to 1,000 deaths annually.
Risk factors include:
Individual predisposition.
The substance exposure route and dosage involved.
Time between exposures.
Page 19: Case Scenario
A 26-year-old male with trouble breathing is described:
Observed leaning forward, indicates distress.
Wife mentions he has pneumonia and just took azithromycin.
Categorize the patient based on presentation, noting urgency and necessary interventions.
Page 20: Immediate Management Actions
Administer high-flow oxygen:
IV access gaining.
Administer 0.3 mg of epinephrine 1:1,000.
Page 21: Monitoring and Further Treatment
Condition improves with communication and slight shortness of breath:
Consider beta-2 agonist therapy.
The importance of repeated doses of epinephrine if needed.
Page 22: Ongoing Transportation and Care
Patient stabilizes, continuity of treatment and monitoring crucial during transport.
Prepare for potential airway management needs.
Page 23: Anatomic Barriers to Exposure
Body mechanisms include:
Epithelium, sebaceous glands, and secretions (sweat, tears).
Defense through mechanical responses: respiratory, urinary, gastrointestinal.
Page 24: Induction of Immune Response
Immune responses must be correctly induced to protect the body.
Page 25: Immune Physiology
Comprised of anatomical and chemical barriers.
Differentiation between nonspecific and specific immune responses, including cellular and humoral immunity.
Page 26: Mast Cell Activation
Activation involves mast cell degranulation in response to allergens.
Release of mediators like histamine.
Page 27: In-Class Exercises on Histamine
Different roles and reactions of histamine during immune response.
Page 28: Effects of Mast Cell Reactions
Representation of biological responses to allergens:
Bronchospasm, tissue edema, decreased cardiac output.
Page 29: Natural vs. Acquired Immunity
Natural immunity is innate; acquired immunity is responsive to exposure:
Active immunity: Exposure-induced response.
Passive immunity: Gained from outside sources.
Page 30: Acute Inflammatory Response
Covering elements such as:
Mast cell degranulation, vasodilation, inflammation progression.
Page 31: Mechanisms of Allergy Exposure
Major exposure routes include inhalation, ingestion, injection, and absorption.
Page 32: Sensitization Process
Overproduction of IgE leads to allergic responses.
Attachment to mast cells, initiating a response to allergens.
Page 33: Synthesis of Chemical Mediators
Mast cells contribute to inflammation with:
Leukotrienes, prostaglandins, histamines.
Page 34: Secondary Immune Response
Reexposure to antigens activates memory response via antibodies.
Page 35: Abnormal Immune Response Examples
Allergies can range from mild (hay fever) to severe (anaphylaxis).
Page 36: Signs and Symptoms of Anaphylaxis
Key indicators include:
Skin: Warmth, hives, and itching.
Respiratory: Dyspnea, wheezing, throat tightness.
Cardiovascular: Hypotension, tachycardia.
GI: Nausea, abdominal cramping.
CNS: Headache, dizziness, altered mental state.
Page 37: Assessment of Anaphylaxis
Must include a thorough scene and patient assessment followed by focused history.
Page 38: Focused History in Anaphylaxis
Gather details regarding:
Nature of exposure, dosage, and progression of reactions.
Page 39: Comprehensive Allergy History
Previous reactions, medications, and recent intake information are key.
Page 40: Physical Examination Elements
Monitoring includes vital signs, lung sounds, and signs of edema.
Page 41: Ongoing Assessment and Examination
Evaluate effectiveness of treatment and overall patient condition.
Page 42: Management Protocols for Anaphylaxis
Key actions include airway management, epinephrine administration, and IV fluids.
Page 43: Standard Approach and Ongoing Assessment
Criteria include rapid onset illness with concerning skin or mucosal symptoms.
Immediate actions appropriately scaled to severity.
Page 44: Bronchospasm Management
Differentiate between mild/moderate and severe bronchospasm:
Treatment considerations based on level of distress.
Page 45: Anaphylaxis Decision Making
Engage in treatment as per anaphylaxis guidelines and ensure transport.
Page 46: Epinephrine
Understand its action mechanism, dosing, and indications in allergic reactions.
Page 47: Benadryl Management
Explore the mechanism of action and related information for diphenhydramine administration.
Page 48: Allergy Reaction Management Steps
Remove the allergen, support through oxygen and fluids, and administer epinephrine and Benadryl.
Page 49: Patient Education on Allergies
Guidelines on prevention, identification, and emergency contacts.
Page 50: Summary of Key Concepts
Major themes include allergy terminology, immune physiology, pathophysiology of allergies, and treatment protocols.
Pages 51-53: Class Exercises and Vocabulary
Exercises focused on real-case scenarios for practical understanding.
Vocabulary list includes important terms such as allergen, antibody, anaphylaxis, and histamine.