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IMMUNOLOGY (ALLERGIC REACTIONS AND ANAPHYLAXIS)
- 1. Paramedic Care: Principles &Practice Volume 4 Medical Emergencies
- 2. Chapter 5 Allergies andAnaphylaxis
- 3. Topics Pathophysiology Assessment Findings inAnaphylaxis Management of Anaphylaxis Management of Allergic Reactions Patient Education
- 4. Introduction Allergic Reaction – Anexaggerated response by the immune system to a foreign substance
- 5. Introduction Anaphylaxis – An unusualor exaggerated allergic reaction – A life-threatening emergency Injected penicillin and bee and wasp (Hymenoptera) stings are the two most common causes of fatal anaphylaxis
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- 8. Pathophysiology The Immune System –The goal is destruction or inactivation of: Pathogens Abnormal cells Foreign molecules – Cellular Immunity(direct attack) – Humoral Immunity (chemical)
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- 12. Antigen Substance capable ofimmune response
- 13. Antibody Principal agent ofa chemical attack.
- 14. Pathophysiology Immune Response – Exposureto antigen produces primary response. Immune system develops antigen-specific antibodies – Future exposures generate a faster secondary response
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- 17. Primary Response Initial responseto an antigen A ‘memory’ of the cell is developed
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- 20. IgM The Largest Immunoglobin producedduring primary response
- 21. IgD Present in lowconcentrations
- 22. IgA Dominant in bodysecretions
- 23. IgE Principle for allergicreactions
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- 27. Other T Cells Th helpercells Memory Cells
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- 30. Immunity Natural Immunity (Innate) –Genetically predetermined – Everyone is born with it
- 31. Immunity Acquired Immunity – Naturallyacquired (Chicken pox) – Induced active immunity (vaccinations)
- 33. Immunity Passive Immunity- Administrationof antibodies – Natural In the uterus Via breast milk – Induced (tetanus booster)
- 34. Allergies Sensitization – Initial exposureof an individual to an antigen Hypersensitivity – Delayed Results from cellular immunity and does not involve antibodies Commonly results in skin rash Results from exposure to certain drugs or chemicals – Immediate Exposure quickly results in secondary response More severe than delayed hypersensitivity
- 37. Allergies Allergen – Exposure generatessecondary response Large quantities of IgE are released Allergen binds to IgE, causing chemical release Release is “allergic reaction” Includes histamines, heparin, and other substances that are designed to minimize the body’s exposure to an antigen Histamine causes bronchoconstriction, vasodilation, increased gastric motility, and increased vascular permeability
- 38. Histamine A defense mechanismto destroy antigens Released from basophils and Mast cells – H1: bronchoconstriction, contractions of intestines – H2: peripheral vasodilation, secretion of gastric acids
- 39. Histamine Bronchoconstriction – prevents antigenfrom entering lungs. Vasodilation – helps remove antigen from circulation. Secretion of gastric acid – kills ingested antigens.
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- 41. Anaphylaxis Causes – Antigen thatcauses release of the IgE antibodies is referred to as an allergen
- 43. Anaphylaxis Causes – Injections Most anaphylaxisresults from injected allergen Allergen rapidly distributed throughout the body, resulting in massive histamine release
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- 45. Assessment Findings in Anaphylaxis FocusedHistory and Physical Exam – Focused History SAMPLE and OPQRST History Rapid onset, usually 30–60 seconds following exposure Speed of reaction is indicative of severity Previous allergies and reactions – Physical Exam Presence of severe respiratory difficulty is key to differentiating anaphylaxis from allergic reaction
- 46. Physical Exam – Facialor laryngeal edema – Abnormal breath sounds – Hives and urticaria – Hyperactive bowel sounds – Vital sign deterioration as the reaction progresses Assessment Findings in Anaphylaxis
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- 55. Management of Anaphylaxis SceneSafety: – Consider the possibility of trauma Protect the airway – Use airway adjuncts with care – Intubate early in severe cases to prevent total occlusion of the airway – Be prepared to place a surgical airway
- 56. Management of Anaphylaxis Supportbreathing – High-flow, high-concentration oxygen or assisted ventilation if indicated Establish IV access – Patient may be volume-depleted due to “third spacing” of fluid Administer crystalloid solution at appropriate rate Place a second IV line if indicated
- 57. Management of Anaphylaxis Administermedications: – Oxygen – Epinephrine – Antihistamines – Corticosteroids – Vasopressors – Beta-agonists – Other agents Psychological support
- 58. Management of AllergicReactions
- 59. Scene safety Protect theairway Support breathing Establish IV access Administer medications: – Antihistamines – Epinephrine Management of Allergic Reactions © Craig Jackson/In the Dark Photography
- 60. Management of Anaphylaxis andAllergic Reactions Click here to view the management of Anaphylaxis and Allergic Reactions.
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- 62. Patient Education Prevention ofReactions Recognition of Signs/Symptoms – Patient-initiated treatment Epinephrine auto-injectors Desensitization
- 63. Sting Remedies Onion Tobacco Honey Vinegar Baking Soda Meattenderizer Toothpaste Ice Calamine/Benadryl/Cortizone
- 64. Summary Pathophysiology Assessment Findings inAnaphylaxis Management of Anaphylaxis Management of Allergic Reactions Patient Education
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- 68. Not all rashesare urticaria
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