IMPORTANT CLINICAL POINTS: Adrenaline (epinephrine) intramuscularly (IM) in the anterolateral aspect of the middle third of the thigh (safe, easy, effective) Recommended Doses: Child less than 6 years old: 150 micrograms IM (0.15ml 1 in 1000) Child 6 to 12 years old: 300 microgram IM (0.3ml 1 in 1000), Child more than 12 years and Adults: 500 microgram IM (0.5ml 1 in 1000), This Equates to 0.5mg Adrenaline First, then Chlorphenamine DON'T FORGET TO CLICK ON SUBSCRIBE BUTTON :) FOLLOW ME ON Instagram: instagram.com/docwaqasfazal/ Facebook: facebook.com/Drwaqasfazal
To prevent anaphlacting shock can we give any anti allergic medicine prior to give any I/v medicine which you mentioned in your list probably causing anaphlacting shock
what i've learned from the video: 1-anaphylactic shock is acute systemic IgE mediated type I hypersensitivity reaction occuring within minutes to seconds after being exposed to a foreign substance 2- release of histamine in anaphylactic shock causes wheezing, cyanosis, oedema and urticaria 3- management of anaphylactic shock is done by securing airway, give 100% oxygen and intubate if there is still respiratory depression, remove the cause if possible and raise the patients feet to increase the blood flow to the brain 4- give adrenaline intramuscular 0.5 mg and repeat every 5 minutes if no improvement occurs 5- give phenylamine which is an antihistamine to antogonize the action of histamine 6- give hydrocortisone 200mg to suppress the immune response to the allergen 7- give fluids 0.9% to support the blood pressure 8- if the patient is on beta blockers give him Iv salbutamol instead of adrenaline
Thank you so much sir. One question please, a couple days ago, we had a patient who was presented to the ER with dyspnea after an allergic reaction to a contrast dye. The thing is that he was hypertensive not hypotensive. His blood pressure was 180 over 100 !. So the question is, is it also possible for an anaphylactic patient to present with hypertension instead of hypotension?? And does the treatment differ in such case, so can we still give normal saline or Adrenaline?
Doctor, as you mentioned in the video, my father had a similar condition. I would like to know which allergies should be tested and for which drugs. Could you please guide us? Thank you.
Respected Waqas Sir , I am Ravi from Bengaluru and i recently had this Shock . It was by far the one of the most nightmarish situation i have ever experienced. I was literally did not know what to do and I was completely dizzy and for few minutes lost conscious with heavy sweating and already by uritcaria made it unbearable itching. You video has helped me a lot sir for information. May god bless you . Sir my only question is weather this is treatable or not like what should be the idealy way for long term solution
Can you comment or update a video on diagnosing and treating an anaphylactic reaction to alpha-gal allergy from tick bite. This is not as easily diagnosed as other almost immediate allergic reactions as it can take 4-5 hours from the time the red meat trigger was consumed to onset of symptoms and anaphylaxis quickly follows onset. I have alpha-gal, have an epipen, prednisone, Benadryl, and Famotidine in my treatment bag. Dark meat pork is my highest trigger but every once in a while I will build up a higher level sensitivity and have to come off Pork for 6-12 months. Other red meats test much lower on blood test. I have had two hospitalizations in the past 3 years for Anaphylaxis. This past 4th I ate some food that had been cross contaminated and noticed itchy eyes, ears, and a rash starting. I took 50mg benadryl, 40mg pred, and Famotidine, and repeated 4 hours later. Avoided a trip to the ER and was back to normal 24 hours later after taking 25mg of Benadryl the next day qid. I find 50% of the urgent care PA’s have never heard of it and over 30% of internal medicine doctors still today in 2024. 😅
Adrenaline (epinephrine) intramuscularly (IM) in the anterolateral aspect of the middle third of the thigh (safe, easy, effective) Recommended Doses: Child less than 6 years old: 150 micrograms IM (0.15ml 1 in 1000) Child 6 to 12 years old: 300 microgram IM (0.3ml 1 in 1000), Child more than 12 years and Adults: 500 microgram IM (0.5ml 1 in 1000), This Equates to 0.5mg Adrenaline First, then Chlorphenamine
Adrenaline (epinephrine) intramuscularly (IM) in the anterolateral aspect of the middle third of the thigh (safe, easy, effective) Recommended Doses: Child less than 6 years old: 150 micrograms IM (0.15ml 1 in 1000) Child 6 to 12 years old: 300 microgram IM (0.3ml 1 in 1000), Child more than 12 years and Adults: 500 microgram IM (0.5ml 1 in 1000), This Equates to 0.5mg Adrenaline First, then Chlorphenamine
Antihistamine tablets Can be used if patient is not having respiratory airway edema to manage anaphylaxis. If there's respiratory edema then the best thing is epinephrine! Antihistamine won't be effective in such case.
Sir could you please explain the mg /kg body weight and also conversion eg 0.01 ,0.25,etc how to give , im requesting you sir please make. Another video above request
Sir . I am from Bangladesh 🇧🇩 I really like your videos. Sir , Exactly 4 month ago I took a Rabies Ig vaccine then suddenly I feel Dizzy and chest pain .And i was seat down immediately on chair. After 2-3 minutes I started to feel good. I was not going to the hospital this time. I had no skin rash nothing. Just suddenly feel dizzy and had chest pain for 2 minutes. Now after 4 months I have no skin rash. Does it was Anaphylaxis or something? I will be waiting for your Ans. Thank you ❤
Sir what if there is only cutaneous manifestations lip , eyelid edema, erythema, urticaria but no hypotension. Do we still give adr. And what about investigations?
Sir can we give avil(pheniramine maleate)/chlorpheniramine/promethazine injections for allergic reactions triggered by cns depressant drugs like dicyclomine/pregabalin/clonazepam/tramadol/muscle relaxants(thiocolchicoside/tizanidine/chlorzoxazone) etc...and if yes then should we need dose adjust ment aof antihistamines for that.
What is difference if we give phenaramine instead of chlorphenaramine Can phenaramine causes hypotension? If patient is in shock, he is in tachycardia and in such patient if we give adrenaline that will cause further tachycardia... How to manage that Pls sir do reply.. I m in search of answer of these questions Thanks a lot ❤
Mujhe ek madhumakhi ne kata or turant hi mujhe chaakar Aane lag gaye or heart beat badh gyi sans lene me dikaat hone lgi . Shirir me sujan hone lgi Sara sharir suj gya bde bde pimple hone lag gye . Me bohut Bechain hu kuch btaiye . Kya mujhe emergency jaldi se jaldi doctor ke paas Jana chahiye Mujhe yeh anaphylaxis lag raha hai is bar yeh sambhal gya agli bar ye janleba ho sakta hai
IMPORTANT CLINICAL POINTS:
Adrenaline (epinephrine) intramuscularly (IM) in the anterolateral aspect of the middle third of the thigh (safe, easy, effective)
Recommended Doses:
Child less than 6 years old: 150 micrograms IM (0.15ml 1 in 1000)
Child 6 to 12 years old: 300 microgram IM (0.3ml 1 in 1000),
Child more than 12 years and Adults: 500 microgram IM (0.5ml 1 in 1000), This Equates to 0.5mg
Adrenaline First, then Chlorphenamine
DON'T FORGET TO CLICK ON SUBSCRIBE BUTTON :)
FOLLOW ME ON
Instagram: instagram.com/docwaqasfazal/
Facebook: facebook.com/Drwaqasfazal
Do we need to dilute adrenaline?
Thank you so much sir for your efforts .
Is there any role of ionotropic agents such as dopamine?
P PPPpppppp
To prevent anaphlacting shock can we give any anti allergic medicine prior to give any I/v medicine which you mentioned in your list probably causing anaphlacting shock
what i've learned from the video:
1-anaphylactic shock is acute systemic IgE mediated type I hypersensitivity reaction occuring within minutes to seconds after being exposed to a foreign substance
2- release of histamine in anaphylactic shock causes wheezing, cyanosis, oedema and urticaria
3- management of anaphylactic shock is done by securing airway, give 100% oxygen and intubate if there is still respiratory depression, remove the cause if possible and raise the patients feet to increase the blood flow to the brain
4- give adrenaline intramuscular 0.5 mg and repeat every 5 minutes if no improvement occurs
5- give phenylamine which is an antihistamine to antogonize the action of histamine
6- give hydrocortisone 200mg to suppress the immune response to the allergen
7- give fluids 0.9% to support the blood pressure
8- if the patient is on beta blockers give him Iv salbutamol instead of adrenaline
Thanks
Excellent job doc sahib
I m 60 plus dr I find ur videos very helpful in day to day practice though I m a radiologist
Thanks a lot
Thank you very much sir.. I am very happy to hear that. 😊
Thank you very much sir for your crystal clear practical approach of teaching every topic which is useful in clinical practice
Thank you very much. I am glad that you found my videos helpful. I read your all kind comments. So Nice of you. 😊 ❤️
Sir outstanding teaching with excellent conceptual explanation and presentation
I am very because you are my best teacher
So kind of you 😊
Thank you so much for your valuable knowledge
Thank you so much Dr Waqas, you are like an angel, g
keep on educating us.
Keep up doc nice explanation
Addicted to your video's ❤
Sir u r inspiring us to dive in to emergency medicine , making it more ec ,May allah bless u sir ❤
Excellent explanation sir
Great lecture ❤❤
Excellent video
Excellent and explained in such a simple way, please make more videos 🙏
Thank you Lalit 😊
U r really great👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍
So Nice of you Nazia Umar 😊
Zabardast presentation.Thanks Dr.Sahab.JazakAllah!🎉
very Nice doc explained
Doctor Sahab You doing it sooooooo finely, keep it up
Thank you so much sir!!!!!Topic is crystal clear for me now sir!!!!Please upload more stuff sir!!!Regards😇😇
Sure I will. Keep supporting 😊
Nice presentation.
Thanks dr
Excellent presentation.Very clear explanation. Thank you,Sir.
Very good explanation
Thank you Dr. Khalid Ansari 😊
Amazing presentation sir
Very informative, impressive and value able, easy to remember
Glad it was helpful!
thank you sir, for such a wonderful and Comphernsive lecture
So Nice of you. 😊
I learned a lot from here❤
Nice explanation 👍👏👏
Thanks for valuable information
Thanks very much for this wonderful lesson
I read all your comments. So kind of you. Keep supporting 😊
Highly commendable
Very informative. Thank you.
Marvelous!!
بارك الله فيك❤❤❤
Tq very much sir... Very well explained. ..
Verry good sir
hi from UK .. very well explained indeed..!thank you.
Tnx sir for outstanding explanation
Thanks again 🙏
Excellent
Perfect thanks a lot doctor 🌺✨
Tooo good
good work and impormative continue such topics love u sir
Thank you very much Mohsin Khan for your love and support 😊
Amazing
Excellent!
Good tips!
Thanks million time sir ....i first time came to knw that instead of epi. We can give slbutamol n pt on b blocker...
Ramiz Khan I am glad you found it helpful. 😊
Thank u sir.
Ur best
amazing
Thanks a lots sir ❤
Jazak Allah ! Could you please do these topics too ( Electrical injury , drowning , carbon monoxide poisoning )
Thank you very much 🙏
Thank you so much sir. One question please, a couple days ago, we had a patient who was presented to the ER with dyspnea after an allergic reaction to a contrast dye. The thing is that he was hypertensive not hypotensive. His blood pressure was 180 over 100 !.
So the question is, is it also possible for an anaphylactic patient to present with hypertension instead of hypotension?? And does the treatment differ in such case, so can we still give normal saline or Adrenaline?
Sir ,thx.for valuable lecture.
Requested to please upload lecture on noradrenalin (norepinephrine) .
Sure Vikram... I will 😊
Thank you very much sir
Thank u sir
Doctor, as you mentioned in the video, my father had a similar condition. I would like to know which allergies should be tested and for which drugs. Could you please guide us? Thank you.
Can you do a video on rabdo, gi bleed and burns in the er i would greatly appreciate it your videos are beautiful!
I already have a video on esophageal varices bleed and will surely upload more videos on the above mentioned topics. 😊
@@MedNerdDrWaqasFazal thank you so much!
Aoa thanks ❤❤❤❤
Regard, s excllent illusttation
Thank you!
Respected Waqas Sir , I am Ravi from Bengaluru and i recently had this Shock . It was by far the one of the most nightmarish situation i have ever experienced. I was literally did not know what to do and I was completely dizzy and for few minutes lost conscious with heavy sweating and already by uritcaria made it unbearable itching. You video has helped me a lot sir for information. May god bless you .
Sir my only question is weather this is treatable or not like what should be the idealy way for long term solution
Just avoid the thing which triggers it if you know as there is no treatment for this
I have also suffered from this shock
Thank you
Thnaks
Can you comment or update a video on diagnosing and treating an anaphylactic reaction to alpha-gal allergy from tick bite. This is not as easily diagnosed as other almost immediate allergic reactions as it can take 4-5 hours from the time the red meat trigger was consumed to onset of symptoms and anaphylaxis quickly follows onset. I have alpha-gal, have an epipen, prednisone, Benadryl, and Famotidine in my treatment bag. Dark meat pork is my highest trigger but every once in a while I will build up a higher level sensitivity and have to come off Pork for 6-12 months. Other red meats test much lower on blood test. I have had two hospitalizations in the past 3 years for Anaphylaxis. This past 4th I ate some food that had been cross contaminated and noticed itchy eyes, ears, and a rash starting. I took 50mg benadryl, 40mg pred, and Famotidine, and repeated 4 hours later.
Avoided a trip to the ER and was back to normal 24 hours later after taking 25mg of Benadryl the next day qid. I find 50% of the urgent care PA’s have never heard of it and over 30% of internal medicine doctors still today in 2024. 😅
Thanks
Sir Plzz upload more videos on emergency medicine
Btw the asthma treatment, u meant was for acute asthma attack or asthma. And according to gina2022 ics plus a laba such as fulmetrol given now
Sir kindly make vedio on hypersensitivity types
Sure Babar Khan. Stay tuned 😊
Can you please make a video on choice of usage of ionotropes in children.
♥️♥️♥️
If intubation is difficult then cricithyrodotomy with a wide bore needle can be life-saving.
Thank u for the eye opening video! Can i ask for Iv salbutamol in ur last slide, what is the recommended dosem
Sir please make vedio on dose titration in hypertension and diebetes mellitus
Abhay Kairati,sure I will. 😊
Sir
Excellent teacher
Blessed to. Listen
Are there short practical courses in your hospital
I am from AP
Waqas bhae if you can provide us the notes of your videos.it will help us alot in revision.. thank you so much
We can't give directly Adeline to the patient so u should explain how it's is given
Adrenaline (epinephrine) intramuscularly (IM) in the anterolateral aspect of the middle third of the thigh (safe, easy, effective)
Recommended Doses:
Child less than 6 years old: 150 micrograms IM (0.15ml 1 in 1000)
Child 6 to 12 years old: 300 microgram IM (0.3ml 1 in 1000),
Child more than 12 years and Adults: 500 microgram IM (0.5ml 1 in 1000), This Equates to 0.5mg
Adrenaline First, then Chlorphenamine
Can you please tell us about the doses of these medications for infants and children presented with anaphylactic shock in ER
Adrenaline (epinephrine) intramuscularly (IM) in the anterolateral aspect of the middle third of the thigh (safe, easy, effective)
Recommended Doses:
Child less than 6 years old: 150 micrograms IM (0.15ml 1 in 1000)
Child 6 to 12 years old: 300 microgram IM (0.3ml 1 in 1000),
Child more than 12 years and Adults: 500 microgram IM (0.5ml 1 in 1000), This Equates to 0.5mg
Adrenaline First, then Chlorphenamine
@@MedNerdDrWaqasFazal
After how much time we can repeat dose if patient isn't relieving
aisa lagata hai ki ,sarswati maiya aapake tounge mein samayee hui hai
Good information. Can anti-histamine tablets help, if patient had a reaction and is away from hospital?
Antihistamine tablets Can be used if patient is not having respiratory airway edema to manage anaphylaxis. If there's respiratory edema then the best thing is epinephrine! Antihistamine won't be effective in such case.
Cholphermiane and hydrocortisone is out date in uk guidelines..
❤
What is the sulbutamol dose and is it given stat or in infusion.. Plz tell us about dose
In Tachycardia , adr also cause Tachycardia then ?
Sir could you please explain the mg /kg body weight and also conversion eg 0.01 ,0.25,etc how to give , im requesting you sir please make. Another video above request
amazing!
There is no role of antihistamines like avil in anaphylactic shock..?
Sir . I am from Bangladesh 🇧🇩 I really like your videos. Sir , Exactly 4 month ago I took a Rabies Ig vaccine then suddenly I feel Dizzy and chest pain .And i was seat down immediately on chair. After 2-3 minutes I started to feel good. I was not going to the hospital this time. I had no skin rash nothing. Just suddenly feel dizzy and had chest pain for 2 minutes. Now after 4 months I have no skin rash. Does it was Anaphylaxis or something? I will be waiting for your Ans. Thank you ❤
Sir what if there is only cutaneous manifestations lip , eyelid edema, erythema, urticaria but no hypotension. Do we still give adr. And what about investigations?
Sir plz reply
Adrenalin is Epinephrine
Epifen is gabapantene
Are they same?
First
Aslam alekum sir
Sir what will be dose of salbutamol in patients already on beta blocker and can we repeat like adrenaline
Sir what is the reference book which you teach ?
Sir can we give avil(pheniramine maleate)/chlorpheniramine/promethazine injections for allergic reactions triggered by cns depressant drugs like dicyclomine/pregabalin/clonazepam/tramadol/muscle relaxants(thiocolchicoside/tizanidine/chlorzoxazone) etc...and if yes then should we need dose adjust ment aof antihistamines for that.
If the patient is cyanosis, there must be respiratory accidosis. You must give sodium bicarbonate 200 ml infusion immediately.
Not always cynosis is with resp acidosis...if the patient already with low HB..??
Sir can we give Nor adrenaline with a patient having beta blocker since it is a vasoconstrictor and salbutamol?
Doctor can we administrator adrenaline in the deltoid region?
What is difference if we give phenaramine instead of chlorphenaramine
Can phenaramine causes hypotension?
If patient is in shock, he is in tachycardia and in such patient if we give adrenaline that will cause further tachycardia... How to manage that
Pls sir do reply.. I m in search of answer of these questions
Thanks a lot ❤
How to prevent anaphylaxis during antibiotic treatment
Test dose
Mujhe ek madhumakhi ne kata or turant hi mujhe chaakar Aane lag gaye or heart beat badh gyi sans lene me dikaat hone lgi . Shirir me sujan hone lgi Sara sharir suj gya bde bde pimple hone lag gye . Me bohut Bechain hu kuch btaiye . Kya mujhe emergency jaldi se jaldi doctor ke paas Jana chahiye
Mujhe yeh anaphylaxis lag raha hai is bar yeh sambhal gya agli bar ye janleba ho sakta hai
Sir how to give adrenaline iv infusion , at how much rate