work/life
anaphylaxis
S H O C K T A C T I C S
Though not medically trained, practice managers or reception staff are sometimes the fi rst on the scene if an emergency happens in their waiting room. Anaphylaxis can be one of these emergencies. JULIA DENNISON fi nds out what a layperson should do if a patient has an anaphylactic reaction
naphylaxis frightens all of us. It is a serious allergic reaction that comes on rapidly and may lead to death. It can occur in response to almost any foreign substance, but common triggers include things like bee stings, foods, and medication. It can sometimes feel like it’s come out of nowhere, especially for those who may not have been aware of a food allergy – particularly in children, who are more likely to have a severe food allergy than adults. It affects a fairly small amount of people (0.05 to two per cent worldwide), but rates appear to be increasing, so it’s important to know what to do if one of your patients goes into shock in your waiting room.
A
Anaphylaxis is a medical emergency and therefore prompt, but appropriate, treatment is essential. This means you and your staff should be able to recognise the signs and symptoms. The fi rst step is to check a patient’s vital signs and administer basic fi rst aid: 1. Is the patient’s airway clear? If not, clear their dentures, food or anything obstructing it.
2. Is the patient breathing? Listen or watch their chest.
3. Can you feel their pulse?
The signs of anaphylaxis include: Tightening of the throat/diffi culty of breathing
Collapse/loss of consciousness Itchy hives Tingling and swelling of hands, feet, eyelids, mouth, lips and/or genitals
And a sense of impending doom. If you observe these symptoms, call for help – summon one of the doctors and/ or dial 999. “Ask for an ambulance and say ‘anaphylaxis’,” explains Andrew Young, medical information offi cer at ALK. “The patient needs a blue light ambulance to the local emergency department.” The emergency fi rst aid treatment for anaphylaxis is intramuscular (IM) injection of adrenaline. Calling for help must not delay adrenaline injection. If two people are available one should give the adrenaline injection while the other calls 999.
RAPID RESPONSE Patients with known allergies may carry an adrenaline auto-injector (AAI), which contains a single premeasured dose of adrenaline to allow patients with the right training to inject themselves in an emergency while they await medical assistance. The training is
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