Anaphylaxis is no joke! It was the real-life kryptonite that is believed to have killed the Superman actor Christopher Reeve. Previously we have referred to Anaphylaxis as one of the differential diagnoses for hypotension in the mnemonic ‘SHOCKED’.
Anaphylaxis is also dangerous because it has a tricky Biphasic action – an early acute phase and a late second phase that can hit a little later when you think everything is fine. Epinephrine remains the main, number one treatment that acts fast to prevent cardiorespiratory disaster. A quick intramuscular jab on the thigh with an Epi-Pen is a lifesaver. Administering second-line meds right away after Epinephrine such as Benadryl, Steroids, and H2 Histamine-blockers (That act late but last longer) will significantly reduce the intensity of the late second phase. In addition, remember to lay your patient flat if hypotensive and administer IV fluids, and consider Albuterol nebulization for bronchospasm.
So today let’s look at a way to recall quickly the above treatments for Anaphylaxis and help your future patients BE SAFE.
B – Benadryl IV
E – Epinephrine (1st Line treatment)
S – Steroids IV
A – Albuterol nebs/inhaler, Airway assessment
F – Flat-lay the patient, Fluids IV if hypotensive, Fexofenadine / Famotidine
E – Epinephrine repeat if needed
P.S. Book you may like: Anaphylaxis (Medicine & Magic)
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