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CAUTION: THESE NOTES CONTAIN SPOILERS!!!
Case Introduction
A 45 year old female is exposed to peanut butter and shrimp pizza and begins to have an apparent allergic reaction…
Initial Vitals
- Temp 98.8
- HR 130
- RR 35
- BP 70/40
- O2 92%
Critical Actions
- Verbalize Airway Evaluation
- Complete a FOCUSED History and Exam
- Normal Saline Bolus
- Epinephrine both IM and (subsequently) IV
- Glucagon 1mg IV
Final Diagnosis
Refractory Anaphylaxis Due to Beta Blockers
Tips and Tricks
You still need to obtain a quick history and exam even if you know the diagnosis in the first few seconds of the case
Additional Reading
- Basic approach to anaphylaxis (EM Clerkship)
- Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors. (PubMed)
- Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers. (PubMed)