Professional Documents
Culture Documents
Pembimbing:
dr. Dony Siregar Sp.An
Kepaniteraan Klinik
Anestesiologi
RSUD dr. Abdul Aziz Singkawang
2018
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Definitions
What is allergy?
An immune system reaction to a normally
harmless substance (allergen )
• affects 30% of Canadians
• results from interaction of genetic tendency and
sensitization
• includes such things as dust, pets, pollen, molds,
and foods
• cannot be cured but can usually be controlled
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Definitions
What Is Anaphylaxis?
Potentially life-threatening reaction requiring
immediate treatment
Affecting about 2% of Canadians
Involving more than one body system (“systemic”)
Typical triggers include insect stings, medication,
food, natural latex
Trace amounts can cause a severe or even fatal
reaction
Cannot be cured – avoidance is key
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Symptoms
There are a wide variety of potential symptoms
Hives */ Itching *
Change in skin color – flushed / pale
Tingling in mouth (possible early sign)
Nausea or vomiting *
Diarrhea / stomach cramps *
Coughing, wheezing, choking, change in voice
Swelling in lips, tongue, throat, etc.
Difficulty breathing and/or swallowing
Cold clammy skin
Fear, panic and/or sense of doom
Dizziness / light-headedness
Loss of consciousness / coma / death
*Many of these symptoms can result from conditions other than anaphylaxis
but in a person at risk of anaphylaxis they should not be ignored.
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Progression of a Reaction
• Most anaphylactic reactions begin within minutes of
exposure
• In some cases, can occur several hours later (delayed
reaction)
• Some are in two phases (biphasic reaction)
• Biphasic reactions are potentially dangerous if mild
initial symptoms are ignored or under treated (false sense
of security)
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Progression of a Reaction
(continued)
• When someone says a reaction is beginning, take it
seriously!
• Symptoms may be felt before they are noticeable to
others
• It is easier to stop a reaction in its early stages and
epinephrine is most effective if used early
Triggers 8
Possible Triggers of an
Anaphylactic Reaction
Food
Medications
Stinging Insects
Natural Latex
Exercise
Unknown cause (idiopathic)
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Triggers
• Peanuts
• Milk
• Tree nuts
• Wheat
• Fish
• Soy
• Shellfish / Seafood
• Sesame
• Eggs
• Mustard
• Sulphites*
* Sulphites are food additives
Triggers 10
Medications Known to
Trigger Anaphylaxis
• Penicillin and other antibiotics
• ASA (Aspirin)/anti-inflammatory drugs
• Anaesthetic agents
• Radiographic contrast media (used for x-rays)
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Triggers
Stinging Insects
Most Frequent Culprits
• Bees
• Yellow jackets
• Hornets
• Wasps
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Triggers
Natural Latex
Products that may contain natural latex include:
• Surgical gloves
• Dental supplies
• Condoms
• Erasers
• Balloons
• Carpet backing
• Adhesive bandages (e.g., BAND-AID®)
• Medical tubes / supplies
Note: Synthetic latex is not allergenic.
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Triggers
Exercise
Strenuous exercise can trigger anaphylaxis in some
individuals. The following factors may play a role
• Food (that can normally be eaten without problem)
• Medication, weather and menses (menstruation)
• Gender (more women than men are affected)
• Having another allergy
Experts usually advise those at risk of exercise-
induced anaphylaxis not to eat for at least four hours
preceding exercise
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Triggers
Diagnosis
Based on
Medical history of patient and family
Previous reactions
Skin testing and/or blood testing
“Food Challenge” where appropriate
Standard Care
• Most patients will be prescribed an epinephrine auto-
injector to be carried at all times
• Patient education on allergen avoidance is essential
• Patients and caregivers must be taught how to use an
auto-injector and manage reactions
• A MedicAlert® bracelet should be worn
Prevention Strategies
These are the usual recommendations for
patients and their caregivers:
• Learn exactly what allergens have to be avoided
• Be especially careful when eating out, traveling or
far from a medical facility
• Make sure friends, family, caregivers, and medical
professionals know about the allergy
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Prevention Strategies
For Food Allergies:
• Wash hands before/after handling food
• Learn how to read a food label and check ingredient
labels carefully each time
• Do not share drinking cups, straws, and utensils
• Be aware of cross contamination and avoid bulk foods
• If product ingredients are unlisted, check with
manufacturer
• If unsure, DO NOT EAT
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Epinephrine
• Epinephrine is the only proven emergency
treatment for anaphylaxis
• Do not hesitate to use the epinephrine auto-injector
as prescribed; it is easier to stop a reaction in its
early stages
• Harmful side effects are rare
• Beneficial effects of injection should last 15 to
20 minutes, but if symptoms do not subside or if
symptoms recur, a second injection may be needed
within 5 to 15 minutes after the first dose.
Handling Emergencies –
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