Allergic Reaction. A Presentation of EMD Cards for Animal Bites, Stings EMD CE for April 2015

Transcription

1 Allergic Reaction A Presentation of EMD Cards for Animal Bites, Stings EMD CE for April 2015

2 Is an abnormal reaction of the immune system to an otherwise harmless or foreign substance A foreign substance is also called an ANTIGEN The Allergic Process

3 When the body detects an antigen it creates an ANTIBODY Antibodies are proteins produced by the body Most common causes of allergic reaction are: Food, Drugs, Insects, Latex Allergic Process Continued

4 Local Reaction Redness/Swelling/Itching Only at the site of the sting/bite Regional Reaction Extends beyond the sting/bite area Usually resolves itself Anaphylactic Reaction SOB (Shortness of Breath), Hoarse Voice, Swelling of Tongue EMERGENCY SITUATION Stages of Allergic Reaction

5 Hives

6 Hives

7 Life Threatening Reaction that occurs within seconds/minutes of exposure. Symptoms progress rapidly Anaphylactic Reaction

8 Drop in Blood Pressure- Shock symptoms Airway Closes Rapid, Weak Pulse Rash Nausea and Vomiting Anaphylactic Reaction Symptoms

9 Airway Concerns

10 Before and After

11 Requires ER Trip Needs Epinephrine to counteract Epinephrine (Epi) is given by paramedics. Epi Pens contain Epi and can be given by untrained people. Treatment of Anaphylaxis

12 Illinois Region 8 Emergency Medical Services Central DuPage, Edward, Good Samaritan, Loyola EMS Systems Standard Operating Procedures ADULT ALLERGIC REACTION / ANAPHYLAXIS BLS/ALS 1. Initial Medical Care SOP, p Apply ice/cold pack to site 3. BLS: at the direction of Medical Control, administer one dose EPINEPHRINE autoinjector (EpiPen ) Loyola SOP

13 Contain an emergency dose of epinephrine Come in Pediatric and Adult Dosage Are Prescription Only- for people with recognized risks Epi-Pens are very common and must be used correctly, on the appropriate person. Never allow someone to use their Epi-Pen on someone else. Epi Pens

14 Using the Epi Pen

15 Using the Epi Pen Continued

16 Elapid snakes are found in North America, and other countries. Usually found in the desert southwest Also found at the Zoo Have hollow fangs Can inject a large quantity of Venom and are therefore very poisonous. Unlike Bees, snakes will continue to bite and attack if threatened. Elapid Snakes

17 These snakes give off a neurotoxin. Neurotoxins directly affect the central nervous system (Brain and nerves). The venom is so toxic as it kills at least 50% of the people it bites Loyola has anti-venom, as does Brookfield Zoo. The anti-venom is generally transported by Zoo personnel with the patient. Elapid Continued

18 Elapid Snake Bites Will also cause a type of Anticoagulation (inability to clot) Results in severe bleeding and death. Do not apply Tourniquets for snake bites Elapid=Poisonous

19 Because people keep some strange animals in their houses. Franklin Park FD had a ZOO worth of animals removed after a house fire a few years ago. Why am I worried about snakes??

20 Exotic animals are defined as any animal or insect that may be considered poisonous, dangerous or of unknown risk. I m Unique

21 SNAKEBITE / ENVENOMATION BLS/ALS Scene Size-Up 1. Assess scene and personal safety 2. Use standard precautions on all patients Initial Medical Care SOP, Special considerations Allow patient to lie flat and avoid as much movement as possible. Keep patient calm. Allow the bitten limb to rest at level of the patient's heart. LOYOLA SOP

22 Medical Control should be contacted immediately whenever snakebite is suspected. Notify Medical Control if antivenin is available at the scene. Request that Medical Control contact toxicologist/poison Center ASAP at Notify Medical Control of type of snake. If safe to do so, obtain photo of snake for identification. If compression wrap has been applied by special services staff (e.g. animal control or zoological park), do not remove. DO NOT apply ice, heat, tourniquet or incise wound. LOYOLA SOP

23 As 911 Dispatchers we often get called for things other than what is really happening: Shortness of Breath that is actually an allergic reaction (treat under Allergic reaction protocol) Allergic reactions that are really food intolerances (Treat under sick person) Allergy Mimics

24 Stuffy Noses described as difficulty breathing (treat under sick person) Itchy, Watery eyes, described as Allergies (treat under allergic reaction) Allergy Mimics

25 Hay Fever- Also known as allergic rhinitis Food Allergies- people complain of lactose intolerance, gluten allergies, soy allergies etc. Animal Allergy-Pet dander is composed of tiny, even microscopic, flecks of skin shed by cats, dogs, rodents, birds and other animals with fur or feathers. These bits of skin can cause reactions in people who are specifically allergic to these triggers (American Lung). Common Complaints

26 Gluten is a protein found primarily in wheat, barley and rye. If a person has a gluten intolerance, this protein can cause digestive problems such as gassiness, abdominal pain or diarrhea. Gluten intolerance is sometimes confused with Celiac disease, or thought of as a food allergy. While avoiding particular foods is a treatment strategy for all three, these are not the same conditions. Food intolerances such as gluten involve the digestive system. With a food allergy, the immune system overreacts to a particular food causing symptoms that are potentially serious or even live threatening. Celiac disease is an inherited autoimmune disorder that can damage the small intestine. (American Academy of Allergy, Asthma and Immunology) Gluten Allergy-Not an allergy

27 Pink Eye- NOT an Allergy

28 Pollen. Pollen is very fine powder that comes from trees, grasses, flowers and weeds. Wind and birds carry this pollen from plant to plant to fertilize them. When people who have a pollen allergy inhale the pollen, they get allergy symptoms. People can be allergic to different types of pollen. For instance, some are allergic to pollen from only beech trees; others are allergic to pollen from only certain kinds of grasses. Seasonal Allergies

29 Mold. Mold is a fungus, which makes spores. These spores float in the air like pollen. When people who have a mold allergy inhale the spores, they get allergy symptoms. Molds live indoors (especially in moist places like bathrooms, kitchens, and basements) and outdoors (on rotting logs and fallen leaves). Seasonal Allergies

30 Pollen and mold spores in the air enter the nose and throat. They can cause allergy and asthma symptoms in people who are allergic to them. Asthma is a lung disease that makes it hard to breathe at times. When people with asthma come into contact with something they are allergic or sensitive to, their airways become narrower. That makes it harder for air to get to their lungs. Symptoms include coughing, wheezing (a whistling sound when a person breathes) and a feeling of tightness in the chest. (American College of Allergy, Asthma and Immunology) Seasonal Allergies

31 The difference in a seasonal allergy asthma attack and an anaphylactic reaction is the lack of swelling. Anaphylaxis results in airway swelling such as the face, tongue and lips Asthma only affects the lungs and has NO swelling Asthma Attack vs. Anaphylaxis

32 Allergic Reaction Protocol Also covers stings and spider/snake bites Not for animal bites Protocol instructs us to advise to take their medications Protocol gives instructions for snakebites Protocol 02 (Priority System)- Allergies/Stings (Powerphone)

33 Insect bites are rarely life threatening UNLESS a priority symptom is present. Priority symptoms are: Shortness of breath Swelling of face, tongue or lips Known reaction to the insect Are they going to die???

34 Is this the patient s medicine? Do they have a History of this problem? If yes, what instructions did they receive from the Doctor regarding medicine if this happened? IF A PATIENT USES an EPI Pen, they MUST go to the hospital. Stay on the phone with them until Medics arrive. Medication Considerations

35 Animal Bites/Attacks Premise here is that there is trauma, unlike a bee sting Safety is a factor Protocol 03 (Priority System)/ Animal Bites (Powerphone)

36 SCENE SAFETY- for bystanders and responders. Monitor ABC s Control Bleeding, Treat for Shock Administer Medicine if Necessary/Appropriate Priorities

37 References es_quiz/quiz.htm Apco Public Safety Magazine, September 2012 American Lung Association: -air/home/resources/petdander-1.html