Anaphylactic Shock Treatment

How do we as paramedics manage Anaphylaxis? Anaphylactic shock treatment is one of the few medical treatments used as a paramedic in which you are able to clearly see that you have saved a persons life. The following are guidelines on how to treat anaphylactic shock.

Anaphylactic Shock Treatment for Adults

Airways may be compromised due to laryngeal and eppiglotic oedeama. Good airway management is critical! This includes insertion of nasopharyngeal airways and, if laryngeal or eppiglotic oedema develop, immediate intubation, as a golden standard of airway management.

Breathing may become difficult and should be assisted with intermittent positive pressure ventilation (IPPV) if necessary via bag valve mask

Circulation may be compromised as a result of relative hypovolaemia, and should be treated accordingly with adrenaline and fluid resuscitation.

Mainstream paramedic treatment for adults in anaphylaxis includes:

Administration of patient’s own “Epipen” if available.

Posturing should depend on the patient’s comfort. Normally, we lie hypovolaemic patients supine or with their legs raised, but this is unlikely to be possible if the person is have severe breathing problems which is often the more likely response to anaphylaxis than the hypotension.

Drugs: 500mcgs Intramuscular Injection of Adrenaline repeated every 5 minutes until desired result. Evidence based practice has indicated that IV adrenaline has no greater benefits to the patient, but many more potentially lethal risks associated with it. Oxygen should be administered. IV fluids should be given if the patient is hypovolaemic. Nebulisers should be considered as a secondary priority in patients with severe breathing difficulties (after adrenaline administration). Nebulisers should include: salbutamol and atrovent.

Any patient given adrenaline should always have a cardiac monitor applied (in case the adrenaline exacerbates a previous known or unknown underlying cardiac condition or dysrhythmia).