Protocols for anaphylaxis

For the 3062 presentation we had an anaphylaxis case study and this is just a summary from memory of the clinical protocols:

A patient's hypersensitivity reaction may occur as redness or urticaria (Rash), breathing problems from bronchospasm or odema, systemic odema. Oral manifestations include  Pruritus of lips, tongue and palate, edema of lips and tongue.

If there is suspicion of an allergic reaction or an allergen has been administered e.g. LA, penicillin then administer 10mg chloramphenamine and 100mg hydrocortisone. Lie the patient down to counter hypotension unless there is airway involvement then keep the patient upright. Administer oxygen if symptoms appear and if there are serious symptoms or breathing problems then administer 1:1000 epinephrine  Intramuscularly via epipen in lateral of thigh or arm. You may need to readminister adrenaline every 5 minutes or so due to adrenaline's low half life until the chloramphenamine has taken effect. If serious symptoms with fast onset occurs then adrenaline is the first line action as its action is lifesaving causing bronchodilation and vasoconstriction which counters histamine's effects. Chloramphenamine then hydrocortisone are next urgent as they are slower acting. Call an ambulance as soon as anaphylaxis is suspected and arrange secondary care as a late phase reaction may occur 2-8 ours later due to the action of cytokines.