Customized Anaphylaxis Guidelines for Emergency Medicine. L’anafilassi in medicina d’urgenza.

28 Ago

Molti episodi di anafilassi vengono gestiti in fase preospedaliera ed in Pronto Soccorso dai professionisti di medicina d’urgenza.

La manifestazione dell’anafilassi in questi setting è spesso diverso da quello che si presenta allo specialista allergologo.

Molti dati fanno intravedere come in emergenza l’anafilassi viene spesso miscomosciuta ed il suo trattamento è spesso inadeguato per mancanza di linee guida e protocolli adeguati alla medicina d’urgenza.

In questo lavoro pubblicato sul Journal of Emergency Medicine gli autori adeguano le attuali linee guida sull’anafilassi per l’utilizzo da parte del professionista sanitario che lavora in emergenza medica sia intra che extraospedaliera.

Most episodes of anaphylaxis are managed in emergency medical settings, where the cardinal signs and symptoms often differ from those observed in the allergy clinic. Data suggest that low recognition of anaphylaxis in the emergency setting may relate to inaccurate coding and lack of a standard, practical definition.
In the following article published on Journal of Emergency Medicine the actual guidelines on Anaphylaxis are customized for prehospital and ED professionals.

Anaphylaxis Guidelines for Emergency Medicine J Emerg Med. 2013;45(2):299-306.

Bottom line:

Focus on diagnosis! Don’t miss anaphylaxis!

  • It is important to recognize that the patient may not present with life-threatening symptoms.

  • Even when the initial symptoms are mild, there is significant potential for rapid progression to a severe reaction, which may prove fatal.

  • It often is impossible to predict the ultimate severity of an anaphylactic episode at the time of onset.

  • Any delay in appropriate treatment increases the potential for morbidity and mortality.

Give i.m. epinephrine as first line treatment when anaphylaxis in the most likely diagnosis!

  • The dose is 0.01 mg/kg of a 1:1000 (1 mg/mL)solution to a maximum of 0.5 mg in adults or 0.3 mg in children. Depending on the severity of the episode and the response to the initial injection, this dose can be repeated every 5–15 min as needed.

  • There are no absolute contraindications to the use of Epinephrine for Anaphylaxis. Serious adverse effects are very rare when Epinephrine is administered at the appropriate Intramuscular doses for anaphylaxis.




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