EMERGENCY TREATMENT OF ALLERGIC REACTIONS IN DENTAL OFFICE TRATAMENTO EMERGENCIAL DE REAÇÕES ALÉRGICAS NO CONSULTÓRIO ODONTOLÓGICO
|
|
- Bertram Foster
- 8 years ago
- Views:
Transcription
1 480 EMERGENCY TREATMENT OF ALLERGIC REACTIONS IN DENTAL OFFICE TRATAMENTO EMERGENCIAL DE REAÇÕES ALÉRGICAS NO CONSULTÓRIO ODONTOLÓGICO Paulo Ricardo Saquete MARTINS-FILHO * Thiago de Santana SANTOS ** Clóvis MARZOLA *** Heitor Fontes da SILVA **** Daniel Galvão COSTA **** * Master of Health Sciences, Center of Postgraduate Medicine, Sergipe Federal University. ** Buco Maxillofacial Surgeon, School of Dentistry, University of Pernambuco. *** Professor of Surgery, Faculty of Dentistry of Bauru, USP, and retired Professor of specialization courses and Residency in Oral and Maxillofacial Surgery Maxillofacial promoted by the Brazilian College of Surgery and Traummatology BMF, Base Hospital Association's Hospital of Bauru and Regional APCD of Bauru. **** Academic School of Dentistry, Federal University of Sergipe.
2 481 ABSTRACT Allergic reactions are an important part of the complications that occur in the dental office and can be divided into late and immediate reactions. The dental professional has, therefore, the responsibility to prevent and treat these complications in their work environment. The aim of this study is, through a review of the literature, discussing the emergency treatment of allergic reactions that can develop in the dental office. RESUMO As reações alérgicas constituem uma fração importante das complicações que ocorrem no consultório odontológico e podem ser divididas em reações alérgicas imediatas e tardias. O profissional da área odontológica tem desta forma, a responsabilidade de prevenir e tratar estas intercorrências em seu ambiente de trabalho. O objetivo deste trabalho é, através de uma revisão da literatura, abordar o tratamento emergencial das reações alérgicas que podem se desenvolver no consultório odontológico. Uniterms: Allergic reactions; anesthetic; anaphylaxis. Unitermos: Reações alérgicas; anestesia; anafilaxia. INTRODUCTION Hypersensitivity reactions arising from the restatement of an organism to a particular allergen, presenting itself as a reaction affecting the tissues, called allergic reaction (CALICH; VAZ, 1989). Allergic reactions may be manifested by local anesthetics, although the incidence has decreased since the introduction of amide anesthetics in the 1940s. Lately there have reported allergic reactions to bisulfite or sodium metabisulfite, and antioxidant stabilizing agent present in vials of local anesthetic for dental use that contain vasoconstrictors (CAMPBELL; MAESTRELLO; CAMPBELL, 2001 e MALAMED, 2001). Special attention should be given to the administration of local anesthetics with adrenaline in the cortical-dependent asthmatics due to a higher risk of immediate and severe allergic reactions, especially in cases of intravascular injections (VASCONCELLOS; NOGUEIRA; LEAL et al., 2002). Drugs commonly used in dental practice, as penicillins, aspirin and NSAIDs, and other substances such as latex and methyl methacrylate which has to be a monomer of acrylic resins, can also trigger allergic reactions (ANDRADE; RANALI, 2002). Allergic reactions include a wide spectrum of clinical manifestations, ranging from mild and late responses to immediate and lethal reactions that develop seconds after exposure to the allergen. This is of great importance in Dentistry and comes fully justify the preparation of this work to the general practitioner.
3 482 Delayed Allergic Reactions Signs and symptoms related to allergic disorders are mediated primarily by the delayed release of histamine, which, acting at the level of skin, stimulates the nerve endings naked, causing rashes. Furthermore, histamine produces arteriolar vasodilation and increased capillary permeability, causing localized swelling and in some cases, generalized (SINGI, 1998). Histamine also has action on the bronchial smooth muscles, contracting them and causing bronchoconstriction (SILVA, 1994). The treatment of allergic late based on the severity of the table by the patient, which generally ranges from mild to moderate (Table 1). In a case report published recently, the patient developed swelling of the lips, face and eyelids after injection of articaine without symptoms of systemic order, with resolution of the case with administration of corticosteroids (EL-QUTOB; MORALES; PELÁEZ, 2003). The photos below illustrate a case of contact allergy after the use of povidone-iodine antisepsis for extra-oral, with promethazine treatment-based IM and dexchlorpheniramine in a single dose orally for 02 days (Fig. 1). Figure 1 - Allergic reaction after topical application of povidone-iodine. The patient developed erythema and itching in the area of contact with the product. Table 1 - Treatment protocol suggested for the late allergic reactions. Light Tables (Discrete urticarial lesions) Promethazine 01 amp. (50mg), IM Dexchlorfeniramine 01 tablet (2mg) from 06/06 hours, VO Moderated Tables (Diffuse urticarial lesions and / or angioedema of the face, without associated systemic manifestations) Adrenalina 1:1000; 0,2 to 0,3ml subcutaneous Promethazine 01 amp. (50 mg), IM Hydrocortisone 01 amp. (100mg), IM Dexchlorfeniramine 01 tablet (2mg) from 06/06 hours, VO Source: Marzola, C. Anestesiologia. São Paulo: Ed. Pancast, 1999.
4 483 In cases of bronchospasm, there should be the same approach adopted for a moderate allergic reactions late traders can use oxygen therapy is 5 to 6 liters / minute, with a mist agonist for 8 to 10 minutes. To perform the mist, you can use 5 to 8 drops of fenoterol diluted in 5ml of 0.9% or 0.5 ml of salbutamol in 2ml of 0.9%. Immediate Allergic Reactions Immediate reactions are anaphylactic or systemic reactions mediated by excessive formation of specific IgE antibodies, with a rapid release of potent mediators of mast cells and basophils (CALICH; VAZ, 1989). Differently localized reactions, usually mediated by histamine, there are additional release of leukotrienes, which are more reactive than histamine, determining responses characterized by signs and symptoms much more intense (ANDRADE; RANALI, 2002). The severity of anaphylactic reactions is also closely related to the rapidity of onset of symptoms, the delay in initiating treatment and prior history of asthma. Signs and symptoms anaphylactic dominant in different systems may be involved (Quadro 2): Table 2 - Signs and symptoms of anaphylactic reaction. Systems Neurological Eyes Upper Airway Lower Airway Cardiovascular Skin Gastrointestinal Manifestações Convulsions, stupor, syncope Itchy, watery eyes Nasal congestion, stridor, laryngeal edema, cough, obstruction Dyspnea, bronchospasm, cyanosis, respiratory arrest Tachycardia, hypotension, myocardial ischemia, cardiac arrest. Erythema, pruritus, urticaria, angioedema, maculopapular rash. Nausea, vomiting, abdominal pain, diarrhea. Source: Ellis, A. K.; Day, J. H. Diagnosis and management of anaphylaxis. CMAJ., v. 169, n. 4, p , It is important to emphasize that true allergic reactions should be differentiated from those related to fear of dental treatment, since anxiety can cause reactions such as psychogenic and vaso vagal. In a study of 5018 patients who received local anesthetics for dental treatment, it was observed that only 0.5% developed some type of reaction after the anesthetic injection. Of these, 88% had reactions in the range of 30 minutes after application of anesthesia, where the most common clinical presentation was dizziness, sweating and loss of consciousness. The authors concluded that in any situation a true allergic reaction was observed and all cases were related to anxiety of dental treatment. The recognition of these situations also has a direct influence in the emergency treatment instituted, since the patients reported symptoms revert the table after
5 484 being placed supine or Trendelenburg (BALUGA; CASAMAYOU; CAROZZI et al., 2002). The initial approach, the most important is the suspected reaction, although there is no order of appearance of the signs, the picture may settle gradually or catastrophically. Anyway, the anaphylactic reaction is a condition of absolute emergency, making it necessary to maintain oxygenation and perfusion of vital organs by blocking the action of chemical mediators, until the arrival of an emergency team to transfer the patient to the environment hospit (PRADO; SILVA, 1999). Immediate treatment against this type of allergic reaction is thus in keeping the patient supine and institute measures for basic life support (ABC) (Table 3). At the same time, should be administered 0.01 ml / kg of epinephrine at a maximum of 0.5 ml subcutaneously, and observe the evolution of the patient. This dosage can be repeated twice at intervals of 20 minutes if necessary. Intramuscular administration of epinephrine should be reserved for severe cases of anaphylactic reaction, since this pathway promotes more rapid absorption and higher plasma levels of the drug (CANADA COMMUNICABLE DISEASE REPORT, 1996 and PRADO; SILVA, 1999). The administration of epinephrine reverses the hypotension (α activity), increases myocardial contractility and blood pressure (β1 activity), and promote a bronchodilatation (β2 activity) (PRADO; SILVA, 1999). Table 3 - Measures of basic life support against anaphylactic reactions unresponsive to initial administration of adrenaline. ABC Observing Behaviour A (Air way) Tongue edema Swelling of lips Cough Hoarseness Oxygen delivery (6 8 l/min) Emergency intubation or cricothyroidotomy. B (Breathing) C (Circulation) Wheezing Subcrepitation Tachycardia Hypotension β2 agonist nebulization (Salbutamol 2,5 to 5 mg in 3 ml of SF 0,9%) Rapid infusion of SF 0,9% (20 mg/kg) Source: Prado, E.; Silva, M. J. B. Anafilaxia e reações alérgicas. J. Pediatria, v. 72, supl.2, p , For patients not responding adequately to epinephrine or to cases where the transfer to an intensive care unit cannot be done in the next 30 minutes, a dose of diphenhydramine hydrochloride may be administered. The approximate dose of the drug, according to age, can be observed (Table 4). In frames of greater stability, can be administered hydrocortisone (100 mg) and promethazine (50mg), intramuscular (ANDRADE; RANALI, 2002).
6 485 Although 80% of cases are unifasics, there are risks of a new crisis (biphasic reaction) from 1 to 8 hours after the initial symptoms. Thus, keeping the patient in a hospital setting and under specialist care should be made for 12 to 24 hours after stabilization, with maintenance of antihistamines and steroids (ELLIS; DAY, 2003). Table 4 - Approximate doses of diphenhydramine for treatment of anaphylactic reaction. Dose Idade Intramuscular Oral < 2 anos 0,25 ml 12,5 mg 2-4 anos 0,5 ml 25 mg 5-11 anos 1,0 ml 50 mg 12 anos 2,0 ml 100 mg Source: Canada Communicable Disease Report. Can. Med. Assoc. J. v. 54, p , FINAL CONSIDERATIONS It is for the dentist to prescribe and implement emergency medication in case of serious accidents that endanger the lives and health of the patient (Lei 5081/66, Art. 6º, VIII). During the interview, it is necessary to seek information about the patient being allergic to certain chemicals. The owner must be prepared to prevent, diagnose and treat complications of allergic reactions that may occur in the dental office. REFERENCES * ANDRADE, E. D.; RANALI, J. Emergências Médicas em Odontologia. Artes Médicas, BALUGA, J.C.; CASAMAYOU, R.; CAROZZI, E. et al., Allergy to local anaesthetics in dentistry. Mith or reality? Allergol et Immunopathol., v. 30, n. 1, p.14-9, CALICH, V. L. G.; VAZ, C. A. C. Imunologia Básica. Porto Alegre: Ed. Artes Médicas, CAMPBELL, J. R.; MAESTRELLO, C. L.; CAMPBELL, R. L. Allergic response to metabisulfite in lidocaine anesthetic solution. Anesth. Prog., v. 48, p. 21-6, * According of the ABNT norms.
7 486 CANADA COMMUNOCABLE DISEASE REPORT. Anaphylaxis: statement on initial management in non-hospital settings. CMAJ., v. 154, p , EL-QUTOB, D.; MORALES, C.; PELÁEZ, A. Allergic reaction caused by articaine. Allergol Immunopathol., v. 33, n. 2, p.115-6, ELLIS, A. K.; DAY, J. H. Diagnosis and management of anaphylaxis. CMAJ., v.169, n.4, p , MALAMED, S. F. Manual de Anestesia Local. Rio de Janeiro: Ed. Guanabara/Koogan, MARZOLA, C. Anestesiologia. Panamericana: São Paulo, PRADO, E.; SILVA, M. J. B. Anafilaxia e reações alérgicas. J. Pediatria, v. 72, supl.2, p , SILVA, P. Farmacologia. Rio de Janeiro: Ed. Guanabara/Koogan, SINGI, G. Fisiologia para Odontologia Atendimento de Pacientes Especiais e Primeiros Socorros Médicos. Rio de Janeiro: Ed. Guanabara/Koogan, VASCONCELLOS, R. J. H.; NOGUEIRA, R. V. B.; LEAL, A. K. R. et al., Alterações sistêmicas decorrentes do uso da lidocaína e prilocaína na prática odontológica. Rev. Cir. Traumat. Buco-Maxilo-Facial, v. 1, n. 2, p. 13-9, o0o
PRIMARY CARE PRACTICE GUIDELINES
1 of 6 1. OUTCOME To identify anaphylaxis in the primary care setting and provide an evidence informed emergency response utilizing the most current provincial and federal practice guidelines. 2. DEFINITIONS
More informationPrimary Care Paramedic. Diphenhydramine (Benadryl) Certification Package
Primary Care Paramedic Diphenhydramine (Benadryl) Certification Package 1 Welcome to the Primary Care Paramedic Diphenhydramine Certification package! The addition of Benadryl to your list of medications
More informationCollege of Licensed Practical Nurses of Alberta. Anaphylaxis Learning Module FOR LICENSED PRACTICAL NURSES
College of Licensed Practical Nurses of Alberta Anaphylaxis Learning Module FOR LICENSED PRACTICAL NURSES February 2005 Adapted from: The College of Licensed Practical Nurses of Alberta Immunization Certificate
More informationAnaphylaxis: Treatment in the Community
: Treatment in the Community is likely if a patient who, within minutes of exposure to a trigger (allergen), develops a sudden illness with rapidly progressing skin changes and life-threatening airway
More informationANAPHYLAXIS. Introduction. Differential Diagnosis. Starship Children s Health Clinical Guideline
Introduction Differential Diagnosis Management Treatment of Anaphylaxis (Flow Chart) Disposition from Emergency Department Adrenaline Autoinjectors Action Plan Adrenaline Autoinjector Information Sheet
More informationSMO: Anaphylaxis and Allergic Reactions
REGION I EMERGENCY MEDICAL SERVICES STANDING MEDICAL ORDERS EMT Basic SMO: Anaphylaxis and Allergic Reactions Overview: Allergic reactions can vary in severity from a mild reaction consisting of hives
More informationAppendix 7 Anaphylaxis Management
Appendix 7 Anaphylaxis Management Anaphylaxis: Initial Management in Non-Hospital Settings This section is intended for the initial management of patients in a public health clinic, medical office or similar
More informationAnaphylaxis Recognition and Out of Hospital Management
Western Canada Immunization Forum Anaphylaxis Recognition and Out of Hospital Management Joy Loewen, Manager Province-wide Immunization Program March 6, 2014 1 Presenter Disclosure Joy Loewen Relationships
More informationWhat Medical Emergencies Should a Dental Office be Prepared to Handle?
What Medical Emergencies Should a Dental Office be Prepared to Handle? Gary Cuttrell, DDS, JD, University of NM Division of Dental Services Santiago Macias, MD, First Choice Community Healthcare Dentists
More informationEmergency treatment of anaphylactic reactions
Emergency treatment of anaphylactic reactions Emergency treatment of anaphylactic reactions Objectives - to understand: What is anaphylaxis? Who gets anaphylaxis? What causes anaphylaxis? How to recognise
More informationProtocol for Management of Suspected Anaphylactic Shock
Protocol for Management of Suspected Anaphylactic Shock COMMUNICABLE DISEASE CONTROL Summary of First Steps for Suspected Anaphylaxis Signs and Symptoms: Within minutes signs/symptoms can develop and do
More informationClinical Performance Director of Nursing Allison Bussey
PGD 0314 Patient Group Direction Administration of Adrenaline (Epinephrine) 1:1000 (1mg/ml) Injection By Registered Nurses employed by South Staffordshire & Shropshire Healthcare Foundation NHS Trust This
More informationEpinephrine & Anaphylaxis To Stick or Not To Stick
Epinephrine & To Stick or Not To Stick William Hurley, MD FACEP Harborview Medical Center hurleyw@u.washington.edu Washington Poison Center hurley@wapc.org Epinephrine & Describe common initiators of anaphylaxis.
More informationInfluenza Vaccine Protocol Agreement (O.C.G.A. Section 43-34-26.1)
Influenza Vaccine Protocol Agreement (O.C.G.A. Section 43-34-26.1) This Influenza Vaccine Protocol Agreement (the "Protocol") authorizes the Georgia licensed pharmacists (the "Pharmacists") or nurses (
More informationAnaphylaxis and other adverse events
Anaphylaxis and other adverse events Aim: To be able to manage anaphylaxis and other adverse events correctly Learning outcomes Define local and systemic adverse events Distinguish between anaphylaxis
More informationtrust clinical guideline
CG04 VERSION 1.0 1/5 Guideline ID CG04 Version 1.0 Title Approved by Allergic Reactions Clinical Effectiveness Group Date Issued 01/01/2013 Review Date 31/12/2016 Directorate Authorised Staff Clinical
More informationCLINICAL PRACTICE GUIDELINE: ANAPHYLAXIS REGISTERED NURSE INITIATED MANAGEMENT AUTHORIZATION: Effective Date: Integrated Professional Practice
CLINICAL PRACTICE GUIDELINE: ANAPHYLAXIS REGISTERED NURSE INITIATED MANAGEMENT AUTHORIZATION: Integrated Professional Practice Council Page 1 of 10 ADAPTED from BC Health Authorities Provincial Decision
More informationMEDICATION MANUAL Policy & Procedure
MEDICATION MANUAL Policy & Procedure TITLE: Section: Initial Management of Anaphylaxis Following Immunization Medication Specific NUMBER: MM 20-005 Date Issued: October 2009 Source: Distribution: Capital
More informationAnaphylaxis before and after the emergency
Anaphylaxis before and after the emergency Mike Levin Paediatric Asthma and Allergy Division University of Cape Town Red Cross Hospital michael.levin@uct.ac.za http://www.scah.uct.ac.za/scah/clinicalservices/medical/allergy
More informationAnaphylaxis and the Role of Diphenhydramine, Epinephrine and Ventolin
Anaphylaxis and the Role of Diphenhydramine, Epinephrine and Ventolin Dwayne Cottel Regional Paramedic Educator Matthew Davis Medical Director of Education Learning Objectives Describe the pathophysiology
More informationEmergency Treatment of Anaphylaxis Policy and Guidelines
Emergency Treatment of Anaphylaxis Policy and Guidelines This procedural document supersedes: PAT/EC 3 v.4 Policy and Guidelines for the Emergency Treatment of Anaphylaxis This procedural document should
More informationAnaphylaxis Management. Pic 1 Severe allergic reaction which led to anaphylaxis
1 Anaphylaxis Management Pic 1 Severe allergic reaction which led to anaphylaxis What is an allergic reaction? 2 An allergy is when someone has a reaction to something (usually a protein) which is either
More informationEmergency Anaphylaxis Management: Opportunities for Improvement. Ronna Campbell, MD, PhD August 31, 2015
Emergency Anaphylaxis Management: Opportunities for Improvement Ronna Campbell, MD, PhD August 31, 2015 disclosures Anaphylaxis Roundtable discussion held at the 2014 American College of Allergy, Asthma
More informationHow to Submit a School Epinephrine Report
1. INTRODUCTION AND INSTRUCTIONS Dear School Nurse, The revised Regulations Governing the Administration of Prescription Medications in Public and Private Schools (105 CMR 210.000) require schools to submit
More informationGlossary of Terms. Section Glossary. of Terms
Glossary of Terms Section Glossary of Terms GLOSSARY Acute: Symptoms which can occur suddenly with a short and severe course. Adrenaclick /Generic Adrenaclick : a single use epinephrine auto-injector that
More informationCHAPTER 21 QUIZ. Handout 21-1. Write the letter of the best answer in the space provided.
Handout 21-1 QUIZ Write the letter of the best answer in the space provided. 1. A severe form of allergic reaction is called A. an allergen. C. epinephrine. B. anaphylaxis. D. an immune reaction. 2. Harmless
More informationAdult Chemotherapy Induced Anaphylaxis Policy
Adult Chemotherapy Induced Anaphylaxis Policy The Beatson West of Scotland Cancer Centre 1053 Great Western Road Glasgow G12 0YN Written by: Elaine Barr Authorised by: D.Dunlop, C. Forte Issue Number :
More informationEmergency Treatment for Vaccine Reactions
Massachusetts Department of Public Health Division of Epidemiology and Immunization Model Standing Orders Emergency Treatment for Vaccine Reactions Note: These model standing orders are current as of December
More informationAnaphylaxis. Exceptional healthcare, personally delivered
Anaphylaxis Exceptional healthcare, personally delivered 2 Introduction Anaphylaxis (also known as anaphylactic shock) is a severe, potentially fatal allergic reaction. Anaphylaxis is caused by your body
More informationGuidelines for anaphylaxis emergency medication (adrenaline [epinephrine] autoinjector) prescription
Guidelines for anaphylaxis emergency medication (adrenaline [epinephrine] autoinjector) prescription Introduction The aim of these guidelines is to outline the appropriate prescription of adrenaline (epinephrine)
More informationGuideline Statement for Treatment of Anaphylactic Reaction in the Surgical Patient
Adopted BOD October 2005 Updated BOD January 2013 Guideline Statement for Treatment of Anaphylactic Reaction in the Surgical Patient Introduction Anaphylaxis, also referred to as an anaphylactic reaction,
More informationTable of Contents. Page
Table of Contents 1.0 Purpose 3 2.0 Scope 3 3.0 Definition of Anaphylaxis 3 4.0 Recognition of Anaphylaxis: General Principles 3 5.0 Recognition of Anaphylactic Reaction 5 6.0 Treatment of Anaphylactic
More informationImmunology, J Allergy Clinical Immunology 1998; Vol.102, No. 2, 173-175.
DATA HEALTH BRIEF: EPINEPHRINE ADMINISTRATION IN SCHOOLS Massachusetts Department of Public Health Bureau of Community Health Access and Promotion School Health Unit August 1, 21 July 31, 211 (School Year
More informationHOMES AND SENIORS SERVICES
Page 1 of 9 PURPOSE: All vaccines have the potential to cause adverse reactions. In order to minimize adverse reactions, clients should be carefully screened for contraindications to a vaccine before it
More information8/6/2010. Name of medication Concentration (1:1,000 or 1mg/1ml) Expiration date
Learning Objectives: Anaphylaxis & Epinephrine Administration by the EMT Adapted with permission from the Pilot Project for the Administration of Epinephrine by Washington EMTs With successful completion
More informationLIFE-THREATENING ALLERGIES POLICY
CODE: C.012 Program LIFE-THREATENING ALLERGIES POLICY CONTENTS 1.0 PRINCIPLES 2.0 POLICY FRAMEWORK 3.0 AUTHORIZATION 1.0 PRINCIPLES 1.1 Halifax Regional School Board will maximize the safety of students
More informationEMERGENCY EPINEPHRINE AUTO-INJECTOR DEVICES Policy Code: 5024/6127/7266
EMERGENCY EPINEPHRINE AUTO-INJECTOR DEVICES Policy Code: 5024/6127/7266 Anaphylaxis is a severe systemic allergic reaction from exposure to allergens that is rapid in onset and can cause death. Many severe
More informationA ragweed pollen as a treatment for a ragweed allergy? It s called immunotherapy.
A ragweed pollen as a treatment for a ragweed allergy? It s called immunotherapy. RAGWITEK is a prescription medicine used for sublingual (under the tongue) immunotherapy to treat ragweed pollen allergies
More informationEMT-B Epinephrine Training Module. Dr. Danielle Campagne Dr. Rawnie Ruegner UCSF-Fresno Department of Emergency Medicine January, 2008
EMT-B Epinephrine Training Module Dr. Danielle Campagne Dr. Rawnie Ruegner UCSF-Fresno Department of Emergency Medicine January, 2008 Objectives Review of Allergic Reactions Review Protocols and Procedure
More informationVaccine Protocol Agreement. Name of Pharmacy: Address: City, State, Zip:
Vaccine Protocol Agreement Name of Pharmacy: Address: City, State, Zip: This Vaccine Protocol Agreement (the "Protocol") authorizes the Georgia licensed pharmacists (the "Pharmacists") or nurses ( Nurses
More informationThe administration of epinephrine for severe anaphylactic type allergic reactions. Training for Québec first aiders 2008
The administration of epinephrine for severe anaphylactic type allergic reactions Training for Québec first aiders 2008 2 Acknowledgements AQAA St-John Ambulance Canadian Red Cross CSST Québec Heart and
More informationAdministering epinephrine for acute anaphylactic type allergic reactions
Administering epinephrine for acute anaphylactic type allergic reactions Training for first aiders in schools People known to be allergic (1.5 hours) MAJ-2013-2 2 Goal of program Reduce the morbidity and
More informationAdverse Events Following Immunisation (AEFI) Noel McCarthy Thames Valley Public Health England Centre and Everybody
Adverse Events Following Immunisation (AEFI) Noel McCarthy Thames Valley Public Health England Centre and Everybody A fifteen year old with diabetes came for his MMR and was referred by the school nurse
More informationEMERGENCY TREATMENT OF ANAPHYLAXIS EPINEPHRINE AUTO-INJECTOR
I. GENERAL GUIDELINES EMERGENCY TREATMENT OF ANAPHYLAXIS EPINEPHRINE AUTO-INJECTOR A. PURPOSE To counteract a severe allergic reaction (anaphylaxis) to a foreign substance as prescribed by the licensed
More informationManagement of an anaphylactic reaction to Omalizumab (Xolair) drug therapy
Management of an anaphylactic reaction to Omalizumab (Xolair) drug therapy Turnberg Building Respiratory Medicine 0161 206 3158 All Rights Reserved 2014. Document for issue as handout. What is an allergic
More informationSection 400: Code # 453.4R
Section 400: Code # 453.4R Administering Medication Conditions for Administering Prescription Drugs Except as otherwise specifically provided by law, a school bus driver, employee, or volunteer that has
More informationPROPHYLACTIC TREATMENT PREVIOUS HISTORY OF REACTIONS
Management of Contrast Media Reactions - Adult Page 1 of 10 Any signs or symptoms of HSR/allergic reaction, notify Radiologist and consider notifying the Diagnostic Imaging Urgent Response Team. If patient
More informationProtocol and Procedures for the Emergency Administration of Epinephrine
M a r i n C o u n t y O f f i c e o f E d u c a t i o n 1111 Las Gallinas Avenue San Rafael California 94903 415-472-4110 Fax: 415-491-6625 www.marinschools.org School District: Protocol and Procedures
More informationAnaphylaxis / Urticaria / Angioedema HSJ 29/02/12
Anaphylaxis / Urticaria / Angioedema HSJ 29/02/12 Case Study Female, 42,? Penicillin Allergy After 1 tab amoxyl, tongue/throat swelling, lips, ears Collapse, given adrenaline Had amoxycillin several times
More informationGet Trained. A Program for School Nurses to Train School Staff in Epinephrine Administration
A Program for School Nurses to Train School Staff in Epinephrine Administration The Get Trained School Nursing Program was created through an unrestricted grant from Mylan Specialty. The Program is intended
More informationPHENYLEPHRINE HYDROCHLORIDE INJECTION USP
PRESCRIBING INFORMATION PHENYLEPHRINE HYDROCHLORIDE INJECTION USP 10 mg/ml Sandoz Canada Inc. Date of Preparation: September 1992 145 Jules-Léger Date of Revision : January 13, 2011 Boucherville, QC, Canada
More informationInsect and Animal Allergens. Stinging Insect Allergy. A Patient s Guide
Insect and Animal Allergens Stinging Insect Allergy A Patient s Guide Stinging insect allergy can cause severe and sometimes life-threatening reactions. Each year, many people are stung by insects such
More informationThis annual data report demonstrates findings consistent with previous reports:
DATA HEALTH BRIEF: EPINEPHRINE ADMINISTRATION IN SCHOOLS Massachusetts Department of Public Health Bureau of Community Health Access and Promotion School Health Unit August 1, 29 July 31, 21 (School Year
More information1.0 ANAPHYLAXIS...1 2.0 ANAPHYLACTIC REACTION VERSUS FAINTING OR ANXIETY...3
May 2012 1.0 ANAPHYLAXIS...1 1.1 DESCRIPTION... 1 TABLE 1: CAUSES OF ANAPHYLAXIS... 1 1.2 PRESENTATION... 2 TABLE 2: CARDINAL SIGNS AND SYMPTOMS OF ANAPHYLAXIS ACCORDING TO CLINICAL PROGRESSION AND SEVERITY
More informationBROCKTON AREA MULTI-SERVICES, INC. MEDICAL PROCEDURE GUIDE. Date(s) Reviewed/Revised:
Page 1 of 5 PROCEDURE FOR: MAP-certified staff and RN/LPN MAP-certified staff are to be trained in the use of epinephrine administration via pre-filled autoinjector devices(s) annually. Certified staff
More informationAdrenaline autoinjector (EpiPen) for acute allergic anaphylaxis
for acute allergic anaphylaxis This review of adrenaline autoinjector was first published in December 2003. This update describes the change to the PBS listing to allow prescribing immediately after hospital
More informationMARYLAND STATE SCHOOL HEALTH SERVICES GUIDELINES
Department of Health and Mental Hygiene Maryland State Department of Education Maryland State School Health Council MARYLAND STATE SCHOOL HEALTH SERVICES GUIDELINES Emergency Management Guidelines for
More informationEpiPen Review For Teachers/Staff CONCORD PUBLIC SCHOOLS CONCORD-CARLISLE REGIONAL SCHOOL DISTRICT
EpiPen Review For Teachers/Staff CONCORD PUBLIC SCHOOLS CONCORD-CARLISLE REGIONAL SCHOOL DISTRICT Objectives: Recognize early signs of an allergic reaction State immediate and safe response Administer
More informationAllergy Action Plan For the 2015-2016 School Year
Allergy Action Plan Student s Name: DOB Grade ALLERGY TO: Asthmatic: Yes*[ ] No [ ] *Higher risk for severe reaction! STEP 1 TREATMENT Symptoms: Give checked medication To be determined by physician authorizing
More informationThe reaction is termed anaphylaxis if there are life-threatening features such as respiratory difficulties and/or hypotension.
HYPERSENSITIVITY AND ANAPHYLACTIC REACTIONS DURING AND AFTER TREATMENT WITH CHEMOTHERAPY- CLINICAL GUIDELINE FOR RECOGNITION AND TREATMENT. 1. Aim/Purpose of this Guideline 1.1. The aim of this document
More informationUpdate on Anaphylaxis: Recognition and Treatment in a College Health Service. Eleanor W Davidson MD Sara H Lee MD February 27 2014
Update on Anaphylaxis: Recognition and Treatment in a College Health Service Eleanor W Davidson MD Sara H Lee MD February 27 2014 Our backgrounds Sara Lee Pediatrics, Adolescent Medicine Faculty, Rainbow
More informationEpinephrine Administration Training for Unlicensed School Personnel
Epinephrine Administration Training for Unlicensed School Personnel Management of Life-Threatening Allergies in the School Setting Dover and Sherborn Schools EpiPen Administration This program is designed
More informationPRESCRIBING INFORMATION PRODUCT MONOGRAPH ADRENALIN* Adrenalin* Chloride Solution (Epinephrine Injection U.S.P) 1:1000 (1 mg/ml)
PRESCRIBING INFORMATION PRODUCT MONOGRAPH ADRENALIN* Adrenalin* Chloride Solution (Epinephrine Injection U.S.P) 1:1000 (1 mg/ml) Adrenalin* Chloride Injection (Epinephrine Injection U.S.P.) 1:1000, 30
More informationPARENT/GUARDIAN REQUEST: ADMINISTRATION OF EMERGENCY EPINEPHRINE, ANAPHYLAXIS CARE PLAN/ IHP & IEHP
IEF Elementary School 105 Andrew Street, Green Brook, N.J. 08812 School Nurse: Mrs. Ostrander Office Phone: 732-9681052 ext. # 3 Fax: 732-968-0791 Green Brook Township Public Schools Green Brook Middle
More informationsite. The patient claims she told her dentist of her reaction to lidocaine. Regardless, he then proceeded to inject 2%
Allergic Response to Metabisulfite in Lidocaine Anesthetic Solution Jeffrey R. Campbell, DDS,*t Christopher L. Maestrello, DDS,t and DDSt Departments of *Pediatric Dentistry, toral and Maxillofacial Surgery,
More information1 What Anapen is and what it is used for?
PACKAGE LEAFLET: INFORMATION FOR THE USER Anapen 500 micrograms in 0.3 ml solution for injection (pre-filled syringe) Adrenaline (Epinephrine) Auto-Injector Read all of this leaflet carefully before you
More informationPERRYSBURG EXEMPTED VILLAGE SCHOOL DISTRICT
PERRYSBURG EXEMPTED VILLAGE SCHOOL DISTRICT MEDICATION IN SCHOOL 5330 F1/page 1 of 5 Before the student will be permitted to take medication during school hours or to use a self-administer medication and
More informationSECTION 12 - ANAPHYLAXIS. Table of Contents
SECTION 12 - ANAPHYLAXIS Table of Contents 1.0 ANAPHYLAXIS... 1 1.1 Description... 1 1.2 Presentation... 1 1.3 Assessment... 2 1.4 Action of Epinepherine... 3 2.0 ANAPHYLAXIS VERSUS FAINTING, ANXIETY,
More informationAnaphylaxis: A Life Threatening Allergic Reaction
Anaphylaxis: A Life Threatening Allergic Reaction What is Anaphylaxis? Anaphylaxis is a sudden, severe, and potentially fatal allergic reaction that can cause a wide range of symptoms, including breathing
More informationSee, Think, and Act! Anaphylaxis (Severe Allergies)
See, Think, and Act! Anaphylaxis (Severe Allergies) California After School Resource Center (CASRC) Administered for the California Department of Education (C.D.E.) Hello. My name is Robyn Sakamoto. Welcome
More informationAdapted from the Ministry of Education BCSTA website. Interior Health
Adapted from the Ministry of Education BCSTA website Interior Health July 2013 WHAT IS AN ALLERGY? Allergies occur when the immune system becomes unusually sensitive and overreacts to common substances
More informationIf#Your#Child#Requires#Medication#While#at#Camp:#
If#Your#Child#Requires#Medication#While#at#Camp:# All prescription and nonprescription medication given in child care, camp or school settingsrequireawritten#authorizationfromyourhealthcareprovider,aswellasparent
More informationEmergency Treatment of an Anaphylactic Reaction in the Community Protocol
Emergency Treatment of an Anaphylactic Reaction in the Community Protocol Reference Number: NHSCT/09/216 Responsible Directorate: Children s Services Replaces (if appropriate): Northern Trust Departmental
More informationYORK REGION DISTRICT SCHOOL BOARD. Policy and Procedure #661.0, Anaphylactic Reactions
WORKING DOCUMENT YORK REGION DISTRICT SCHOOL BOARD Policy and Procedure #661.0, Anaphylactic Reactions The Anaphylactic Reactions policy and procedure address staff responsibilities with regard to providing
More informationALLERGIC REACTIONS. Mary Horvath RN, CSN. M.Ed. Certified School Nurse Bridge Valley Elementary Doyle Elementary
ALLERGIC REACTIONS Mary Horvath RN, CSN. M.Ed. Certified School Nurse Bridge Valley Elementary Doyle Elementary STATISTICS Allergic reactions affect up to 15 million people in the United States, including
More informationTABLE OF CONTENTS 1.0 ANAPHYLAXIS... 1 2.0 ANAPHYLAXIS VERSUS FAINTING, ANXIETY, ALLERGIC REACTION, OR INJECTION SITE REACTION...
Section V Management of Anaphylaxis in a Non-Hospital Setting TABLE OF CONTENTS 1.0 ANAPHYLAXIS... 1 2.0 ANAPHYLAXIS VERSUS FAINTING, ANXIETY, ALLERGIC REACTION, OR INJECTION SITE REACTION... 3 3.0 SUPERVISION
More informationInfluence of ph Most local anesthetics are weak bases.
Local anesthetics The agent must depress nerve conduction. The agent must have both lipophilic and hydrophilic properties to be effective by parenteral injection. Structure-activity relationships The typical
More informationDNH 120 Management of Emergencies
Revised: Fall 2015 DNH 120 Management of Emergencies COURSE OUTLINE Prerequisites: None Course Description: Studies the various medical emergencies and techniques for managing emergencies in the dental
More informationMontelukast Sodium. -A new class of seasonal allergic rhinitis therapy
Montelukast Sodium -A new class of seasonal allergic rhinitis therapy Symptoms of Seasonal Allergic Rhinitis Nasal itch Sneezing Rhinorrhoea Nasal stuffiness Pathogenesis of Allergic Rhinitis Mast cells,
More informationImmunologic Emergencies
Immunologic Emergencies Part 1 You and your partner are dispatched to Pioneer Park, a local recreational area where residents frequently picnic and enjoy a variety of outdoor festivities, especially during
More informationAnaphylaxis - severe allergic reaction
Anaphylaxis - severe allergic reaction Summary Anaphylaxis is the most severe allergic reaction and is a medical emergency. An injection of adrenaline is needed to treat the allergic reaction. The most
More informationPATIENT INFORMATION ABOUT TREATMENTS FOR ASTHMA AND ALLERGIC RHINITIS, PRESCRIPTIONS & OVER THE COUNTER MEDICINE
PATIENT INFORMATION ABOUT TREATMENTS FOR ASTHMA AND ALLERGIC RHINITIS, PRESCRIPTIONS & OVER THE COUNTER MEDICINE The content of this booklet was developed by Allergy UK. MSD reviewed this booklet to comment
More informationAnnual Epinephrine Training Program for Connecticut s Unlicensed School Personnel
Annual Epinephrine Training Program for Connecticut s Unlicensed School Personnel Developed by the Connecticut State Departments of Education and Public Health in consultation with the Connecticut School
More informationREAD THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICINE PATIENT MEDICATION INFORMATION. [new-ka la]
READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICINE PATIENT MEDICATION INFORMATION Pr NUCALA [new-ka la] mepolizumab lyophilized powder for subcutaneous injection Read this carefully before you start
More informationDocument Title: Patient Group Direction for Adrenaline (Epinephrine) 1:1000. http://www.england.nhs.uk/mids-east/ss-at/immunisations/
Document Title: Patient Group Direction for Adrenaline (Epinephrine) 1:1000 Area Team Doc Ref.: PGD Version No.: 06/2014 Doc Ref.: Author: Owner: File Reference: Document Overseeing Group: http://www.england.nhs.uk/mids-east/ss-at/immunisations/
More informationIt is recommended that auto-injector device trainers of each type be available for practice
NASN Get Trained- PA Edition Script A Program for School Nurses to Train School Staff in Epinephrine Administration The Get Trained School Nursing Program was created through an unrestricted grant from
More informationThe Ideal Local Anesthetic. Pain and Anxiety. Percent Solution. Contents cont: Contents of a dental cartridge
The Ideal Local Anesthetic Pain and Anxiety University of Minnesota Division of Oral and Maxillofacial Surgery Ma Ann C. Sabino, DDS PhD Water soluble/stable in solution Non-irritating to nerve Low systemic
More informationTreatments for allergy are usually straightforward, safe and effective. Common treatments include:
Allergy Medications The treatments prescribed for allergy control the symptoms and reactions; they do not cure the condition. However, using treatments as prescribed can show a huge change in a patient
More informationAquarium of the Pacific Food Allergy and Anaphylaxis Protocol
Aquarium of the Pacific Food Allergy and Anaphylaxis Protocol Purpose Statement: The Aquarium of the Pacific recognizes the increasing prevalence of allergies in children, including many life threatening
More informationYes This controlled document shall not be copied in part or whole without the express permission of the author or the author s representative.
Title: Patient Group Direction for the administration of lidocaine hydrochloride 1% injection as infiltration anaesthesia for insertion/removal of central venous catheters by nurses/radiographers working
More informationObjectives COPD. Chronic Obstructive Pulmonary Disease (COPD) 4/19/2011
Objectives Discuss assessment findings and treatment for: Chronic Obstructive Pulmonary Disease Bronchitis Emphysema Asthma Anaphylaxis Other respiratory issues Provide some definitions Chronic Obstructive
More informationFood allergy /anaphylaxis
Food allergy /anaphylaxis A food allergy or hypersensitivity is an abnormal response to a food that is triggered by the immune system. Allergic reactions are often mild, but can be sometimes very dangerous.
More informationAllergies, Anaphylaxis, Adrenaline, and Auto-injectors. Julie Brown, MDCM, MPH Vancouver, Sept 19 th, 2015
Allergies, Anaphylaxis, Adrenaline, and Auto-injectors Julie Brown, MDCM, MPH Vancouver, Sept 19 th, 2015 Overview Case Epidemiology Pathophysiology Clinical Management Emergency Management After the reaction
More informationNew 7/1/2015 MCFRS 1
New 7/1/2015 MCFRS 1 The providers will summarize the need for this change from an epinephrine auto injector The provider will define the proper dosage of epinephrine for the adult and pediatric patient
More informationRecognition and Treatment of Anaphylaxis in the School Setting
Recognition and Treatment of Anaphylaxis in the School Setting Authorization Code of Virginia 54.1-3408. Professional use by practitioners. 2. That the Department of Health, in conjunction with the Department
More informationChapter 18: Immunologic Emergencies
Chapter 18 Immunologic Emergencies Unit Summary After students complete this chapter and the related course work, they will understand the anatomy, physiology, and pathophysiology of hypersensitivity disorders
More informationNEW GUIDELINES FOR USE OF STOCK EPINEPHRINE AUTO-INJECTORS IN WYOMING SCHOOLS
Wyoming Department of Education Cindy Hill, Superintendent of Public Instruction Hathaway Building, 2nd Floor, 2300 Capitol Avenue Cheyenne, WY 82002-0050 Phone: (307) 777-7675 Fax: (307) 777-6234 edu.wyoming.gov
More information404 Section 5 Shock and Resuscitation. Scene Size-up. Primary Assessment. History Taking
404 Section 5 and Resuscitation Scene Size-up Scene Safety Mechanism of Injury (MOI)/ Nature of Illness (NOI) Ensure scene safety and address hazards. Standard precautions should include a minimum of gloves
More informationHemodynamic Effects of 2% Lidocaine with 1:80000 Epinephrine in Inferior Alveolar Nerve Block
4 Hemodynamic Effects of 2% Lidocaine with 1:80000 Epinephrine in Inferior Alveolar Nerve Block ABSTRACT A. Haghighat DDS*, N. Kaviani MD*, R. Panahi DDS** Introduction: Lidocaine plus epinephrine is the
More informationPROTOCOL FOR THE MANAGEMENT OF IMMUNIZATION-RELATED ANAPHYLAXIS IN NON-HOSPITAL SETTINGS
PROTOCOL FOR THE MANAGEMENT OF IMMUNIZATION-RELATED ANAPHYLAXIS IN NON-HOSPITAL SETTINGS Version 1.0 The Office of the Chief Medical Officer of Health Communicable Disease Control Unit Revised February
More information