Round 10 (Allergic Reaction)

CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction A 45 year old female is exposed to peanut butter and shrimp pizza and begins to have an apparent allergic reaction… Initial Vitals * Temp 98.8* HR 130* RR 35* BP 70/40* O2 92% Critical Actions * Verbalize Airway Evaluation* Complete a FOCUSED History and Exam* Normal Saline Bolus* Epinephrine both IM and (subsequently) IV* Glucagon 1mg IV Final Diagnosis Refractory Anaphylaxis Due to Beta Blockers Tips and Tricks You still need to obtain a quick history and exam even if you know the diagnosis in the first few seconds of the case Additional Reading * Basic approach to anaphylaxis (EM Clerkship)* Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors. (PubMed)* Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers. (PubMed)