Anaphylaxis (HB)
Anaphylaxis is a life-threatening condition that is easily treated with a simple medication–epinephrine. This used to be one of the Extended Transport Protocols for Medical Incident Technicians, but as of 2021 is no longer authorized and epinephrine is no longer issued.
It is still important to recognize the signs and symptoms as you may be able to assist a patient with a history of anaphylaxis with their medication or to make the call for an immediate evacuation.
Anaphylaxis occurs when the histamine dump into the circulatory system is excessive. The hives and swelling start occurring throughout the body—not just at the site of the initial allergic reaction. If allowed to progress, the upper airway can swell, and the blood vessels can dilate system-wide causing vascular shock. Untreated, these symptoms can kill the patient in a matter of minutes as the patient can no longer exchange air and the perfusion pressure is inadequate system-wide.
Signs and Symptoms
If the patient starts developing hives, or gastric, or respiratory distress, in conjunction with the local allergic reaction, you should consider these to be red flags and get the patient moving to higher care.
Any time the symptoms appear above the neck you should be more worried.
The patient may present profound mental status changes from vascular shock.
Red Flags
Any signs of anaphylaxis are a red flag and should be treated as an emergent condition with immediate evac to someone that can administer epinephrine. The patient may only have minutes once the anaphylaxis has manifested before they experience a severe change in mental status and death.
Treatment
A patient in anaphylaxis needs 0.3mg of epinephrine administered intramuscularly. If the patient has an “EpiPen” you can help coach them through using it if they are unfamiliar. If they are having issues operating the administration device, you may have to help support their hand as they inject themselves with the medication.