Dr. Ilene Claudius and Dr. Julie Brown discuss anaphylaxis in children, focusing on diagnosing symptoms and challenges, epinephrine administration, supportive interventions, antihistamines and steroids usage, and optimal management and discharge criteria for patients.
Epinephrine is the primary treatment for anaphylaxis, while antihistamines serve as comfort measures.
Diagnostic criteria for anaphylaxis focus on symptoms and precipitating events, with potential advancements in alternative epinephrine delivery forms.
Deep dives
Key Points on Anaphylaxis Definition and Criteria
Anaphylaxis requires exposure and re-exposure to a trigger, leading to a rapid inflammatory response. The diagnostic criteria for anaphylaxis focus on a constellation of symptoms and the precipitating event. Criteria like the NIAD/FAN or SAMPSAN criteria help identify likely anaphylactic events, emphasizing skin involvement, respiratory compromise, reduced blood pressure, or persistent GI symptoms.
Optimal Management of Anaphylaxis
Epinephrine is the primary treatment for anaphylaxis, with supportive interventions like patient positioning and oxygen as necessary. Antihistamines are used for comfort measures but do not alter severe symptoms. Steroids' role in anaphylaxis remains controversial, with considerations for specific cases like asthma history or delayed symptom onset.
Disposition and Follow-up After Anaphylaxis
Patients are observed post-epinephrine administration, with varying admission criteria based on symptom persistence. Lower-risk patients may be discharged sooner with instructions for PR antihistamines and follow-up care. Potential advancements in alternative epinephrine forms like sublingual or intranasal delivery aim to improve ease of use outside medical settings.
The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research.
Today on we have our two renowned experts, Dr. Ilene Claudius and Dr. Julie Brown, discussing the ins and outs of anaphylaxis.
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