Allergic Reactions and Anaphylaxis

<p>Announcements: </p><p>The interactive <a href="https://clinicalpathways.ebmedicine.net/">Clinical Pathways</a> have launched and they are available for free! </p><p></p><p>—</p><p> </p><p>In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the July 2022 Emergency Medicine Practice article on the <a href="https://www.ebmedicine.net/topics/allergic-immunologic-inflammatory/emergency-medicine-allergy-anaphylaxis">Management of Allergic Reactions and Anaphylaxis in the Emergency Department</a>. </p><p> </p><p>Intro</p><ul><li>The number of ED visits and hospitalizations</li><li>Studies show up to 57% of anaphylactic reactions are not recognized, and epinephrine is not administered in up to 80% of cases. </li></ul><p></p><p>Criteria</p><ul><li>2006 Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN)</li><li>WAO revised the criteria in 2020 </li><li>Delphi group and Brown et al</li></ul><p></p><p>Pathophysiology</p><p> </p><p>Epidemiology</p><ul><li>Most common causes in children and adults</li><li>More than half of deaths from anaphylaxis occur within the first hour of symptom onset</li></ul><p></p><p>Prehospital Care</p><ul><li>Give epi, H1 blockers</li><li>Mainstay = recognition</li></ul><p></p><p>ED Care</p><ul><li>Airway</li><li>Epinephrine</li><li>Decontamination</li><li>H1 and H2 blockers</li><li>Corticosteroids</li><li>Biphasic reactions</li><li>Glucagon</li></ul><p></p><p>Special Cases</p><ul><li>Alpha-gal</li><li>Scombroid</li><li>Kounis syndrome</li></ul>