Anaphylaxis at the Clinic - Reel Emergency Episode 9
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- Опубликовано: 14 окт 2024
- EMS clinicians respond to a man having an allergic reaction at an allergy clinic, of all places. Many EMS clinicians have experience responding to clinics of various kinds; what has been your experience interacting with another healthcare team? This EMS crew immediately recognizes the severity of the reaction, and they treat it accordingly with airway interventions and a variety of medications.
Join Drs. Antevy, Spiro and Piehl who review this case with special guest Zach Dunlap, Clinical Director at Cypress Creek EMS in Houston, Texas. Also joining is Maia Dorsett, MD, PhD, Prodigy EMS's medical director.
Reel Emergency covers the latest evidence with real cases in emergency and critical care medicine. Produced in partnership with ReelDx, Handtevy and 410 Medical. CE available from Prodigy EMS at www.prodigyems.com.
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Two Amubulance rides due to anaphylaxis..once, barely alive....it happens so fast.......cramping tummy, nausea, tingling, massive heat through out the body....throat closed instantly.....loss of vision, dizzy, complete weakness....honestly ...to weak to even apply epi.....last event, face, tounge swelling, all over reddness......these systoms are intense!!! Thankful for great EMTs!!
This is very helpful. I went into anaphylactic shock after a yellow jacket sting and my pressure was 40/20. My vision went black and I felt weaker than I ever experienced. Difficulty breathing, profuse sweating. It is so incredibly scary. And it happened so fast. So so fast. Glad med staff is discussing this.
Glad you are okay! Thanks for the comment.
According to UpToDate, "glucocorticoids are commonly given in the treatment of anaphylaxis; however, there is little evidence of benefit. The onset of action of glucocorticoids takes several hours. Therefore, these medications do not relieve the initial symptoms and signs of anaphylaxis".
Great video and resource for providers! Thanks for taking the time to produce this as it's a great 'after action review' of a difficult patient all of us have seen in our clinical practice.
Thanks for watching, Chuck! Be sure to subscribe and keep attending our future casts!
Thank you for posting these!
Glad you like them! Be sure to tune in on Sept. 7 for our next episode!
As far as not being able to ventilate Cardiac Arrest Asthma due to trapping of air ( bag feels har as concrete) I believe I heard on another episode of Reel Emergency > "Bear Hugging" to manually force air out > Hard to perform with continue chest compressions > I have stood over patient and straddled cot, stopped compressions, told airway person to remove bag from ETI/SGA and attempt to push as much air from chest(trying to create as much surface area contact) for 5-6 seconds > reconnect BVM and begin compressions again > repeat process. Bilateral decompression. I like the idea of old school epi does ET (got to talk to MD first), Lastly I have heard the phrase "permissive hypoventilation" in cases like these, where ventilation may only be 4-6 a minute. Thanks for taking to do this show and especially taking the time to discuss the little things it really does matter and clarifies things for me and I would imagine others.
Outstanding thinking! Thank you for your comments and be sure to tune in to future episodes!
Gotta love the clinic 911 calls. Frequently offering great red herring assessments for providers to work through. I’ve seen the oxygen tank empty while patient is “not improving with oxygen,” the “abnormal ecg” with no evidence and just a pointer finger going “right there,” and the “in anaphylaxis” when they have no signs expect anxiety. Fortunately help came in the correct form for this patient. I’ve gone to the method of just taking paperwork, and strictly speaking with the patient, and taking over care with minimal input from staff-I’ll take them to a better facility.
Sounds like you've found the right approach to get the patient the best care possible. Thanks for watching!
Great video! Outstanding work!
Glad you liked it! Keep watching our next episodes!
While it's important to sit him up foot the breathing, isn't it important to stabilize his BP?
Very interesting to watch since I have had a few anaphylaxis episodes. Finally figured I react to inulin, found in powder with stevia packet as well as vegetable forms of inulin. First episode with breathing problems and throat closing, I used liguid benedryl and albuterol iiguid in pressure driven administration until EMTs arrived. I wondered if this patient was on a beta blocker like myself which would impact the effect or lack Thereof the epi. The repeated doses of epi possibly every 5 minutes is important to know. Solumedrol is a drug I will look up.
Was magnesium sulfate ever considered or given?