Refractory anaphylaxis A
Refractory anaphylaxis No improvement in respiratory or cardiovascular symptoms despite 2 appropriate doses of intramuscular adrenaline Cardiac arrest – follow ALS ALGORITHM • Start chest compressions early • Use IV or IO adrenaline bolus (cardiac arrest protocol) • Aggressive fluid resuscitation
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Key recommendations for clinical practice
www.resus.org.ukappropriate adrenaline injector as an interim measure before the specialist allergy assessment (unless the reaction was drug-induced). o Patients prescribed adrenaline auto-injectors (and/or their parents/carers) must receive training in their use, …
Cardiopulmonary resuscitation, automated defibrillators ...
www.resus.org.ukbe as clear-cut if the rescuer isn’t medically qualified, the defence of necessity may be available, provided the rescuer acts reasonably in the circumstances. For instance, it would be reasonable to carry out CPR and use an AED if no healthcare professionals were available. Section 5 of the Mental Capacity Act (England
Emergency treatment of anaphylaxis Guidelines for ...
www.resus.org.ukBristol Royal Hospital for Children Bristol, UK E: nicholas.sargant@uhbw.nhs.uk No relevant conflict of interest Andrew F. Whyte Consultant in Allergy and Immunology Derriford Hospital University Hospitals Plymouth NHS Trust Plymouth UK E: andrew.whyte@nhs.net
Anaphylaxis - resus.org.uk
www.resus.org.uk• Follow REFRACTORY ANAPHYLAXIS ALGORITHM • Remove trigger if possible (e.g. stop any infusion) • Lie patient flat (with or without legs elevated) – A sitting position may make breathing easier – If pregnant, lie on left side Give intramuscular (IM) adrenaline2 Call for HELP Call resuscitation team or ambulance Inject at
Resuscitation Council (UK)
www.resus.org.ukResuscitation Council (UK) EMERGENCY TREATMENT OF ANAPHYLACTIC REACTIONS6 1. Introduction 1.1 Purpose of this guideline The UK incidence of anaphylactic reactions is rising.2 Despite previous guidelines, there is confusion about …
Adult tachycardia - Resus
www.resus.org.ukProbable atrial fibrillation: • Control rate with beta-blocker • Consider digoxin or amiodarone if evidence of heart failure •– Anticoagulate if duration > 48 h Vagal manoeuvres If ineffective: • Give Adenosine (if no pre-excitation) 6 mg rapid IV bolus – If unsuccessful, give 12 mg – If unsuccessful, give 18 mg • Monitor ECG
Decisions relating to cardiopulmonary resuscitation
www.resus.org.ukmay include family, other carers, close friends or others able to support or speak for the patient). This must not prevent discussion, to involve patients in shared decision-making whenever appropriate, or in some circumstances . Decisions relating to cardiopulmonary resuscitation 3 to inform patients of a decision and explain the reasons for ...
Adult Tachycardia (with pulse) Algorithm
www.resus.org.ukAF with bundle branch block treat as for narrow complex Pre-excited AF consider amiodarone If VT (or uncertain rhythm): Amiodarone 300 mg IV over 20-60 min then 900 mg over 24 h If known to be SVT with bundle branch block: Treat as for regular narrow-complex tachycardia Synchronised DC Shock* Up to 3 attempts
Adult advanced life support - Home | Resuscitation Council UK
www.resus.org.uk• Thrombosis – coronary or pulmonary • Tension pneumothorax • Tamponade – cardiac • Toxins Consider ultrasound imaging to identify reversible causes Consider • Coronary angiography/ percutaneous coronary intervention • Mechanical chest compressions to facilitate transfer/treatment • Extracorporeal CPR After ROSC
Paediatric out-of-hospital basic life support
www.resus.org.ukbasic life support Unresponsive Shout for help Open airway 5 rescue breaths Infant: mouth to nose/mouth Child: mouth to mouth If unable/unsafe to ventilate, perform continuous chest compressions Add rescue breaths as soon as possible 30 chest compressions 2 rescue breaths NO or any doubt NO YES YES Breathing normally? If no signs of life observed
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Prescribing Guidelines for Specialist Infant Formula Feeds
www.lancsmmg.nhs.ukwhen an infant has a history of anaphylaxis, and/or has very severe symptoms. 6. Soya products should not be recommended for purchase unless advised by a paediatric consultant or dietitian due to the high incidence of soya sensitivity in infants intolerant of cows’ milk protein (10-35%), and never under 6 months of age. Soya infant milk may ...
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www.rcpch.ac.ukThe Royal College of Paediatrics and Child Health (RCPCH) care pathway for anaphylaxis is presented in two parts: an algorithm with the stages of ideal care and a set of competences . required to diagnose, treat and optimally manage anaphylaxis. The algorithm has numbers which correspond to the competences outlined within the body of the document.
Anaphylaxis - resus.org.uk
www.resus.org.uk• Follow REFRACTORY ANAPHYLAXIS ALGORITHM • Remove trigger if possible (e.g. stop any infusion) • Lie patient flat (with or without legs elevated) – A sitting position may make breathing easier – If pregnant, lie on left side Give intramuscular (IM) adrenaline2 Call for HELP Call resuscitation team or ambulance Inject at