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    (Involvement of The Skin-Mucosal Tissues) : 1.mild

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    Rachel Rios
    This document outlines a grading system and management guidelines for hypersensitivity and anaphylaxis reactions. It defines three grades of reactions - mild (skin involvement only), moderate (respiratory, cardiovascular or GI symptoms), and severe (hypoxia, hypotension, neurological issues). Grade 1 is an acute hypersensitivity reaction while grades 2 and 3 constitute anaphylaxis. The management of anaphylaxis involves stopping the precipitant, administering epinephrine IM, antihistamines, steroids, IV fluids, and monitoring for 2-3 days. Factors that can increase severity include age, allergen type, atopy, cardiovascular disease, asthma, and delayed epinephrine administration.

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    (Involvement of The Skin-Mucosal Tissues) : 1.mild

    Uploaded by

    Rachel Rios
    26 views4 pages
    This document outlines a grading system and management guidelines for hypersensitivity and anaphylaxis reactions. It defines three grades of reactions - mild (skin involvement only), moderate (respiratory, cardiovascular or GI symptoms), and severe (hypoxia, hypotension, neurological issues). Grade 1 is an acute hypersensitivity reaction while grades 2 and 3 constitute anaphylaxis. The management of anaphylaxis involves stopping the precipitant, administering epinephrine IM, antihistamines, steroids, IV fluids, and monitoring for 2-3 days. Factors that can increase severity include age, allergen type, atopy, cardiovascular disease, asthma, and delayed epinephrine administration.

    Original Description:

    hipersensitivitas

    Original Title

    ANAFILAKSIS.

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    This document outlines a grading system and management guidelines for hypersensitivity and anaphylaxis reactions. It defines three grades of reactions - mild (skin involvement only), moderate (respiratory, cardiovascular or GI symptoms), and severe (hypoxia, hypotension, neurological issues). Grade 1 is an acute hypersensitivity reaction while grades 2 and 3 constitute anaphylaxis. The management of anaphylaxis involves stopping the precipitant, administering epinephrine IM, antihistamines, steroids, IV fluids, and monitoring for 2-3 days. Factors that can increase severity include age, allergen type, atopy, cardiovascular disease, asthma, and delayed epinephrine administration.

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    26 views4 pages

    (Involvement of The Skin-Mucosal Tissues) : 1.mild

    Uploaded by

    Rachel Rios
    This document outlines a grading system and management guidelines for hypersensitivity and anaphylaxis reactions. It defines three grades of reactions - mild (skin involvement only), moderate (respiratory, cardiovascular or GI symptoms), and severe (hypoxia, hypotension, neurological issues). Grade 1 is an acute hypersensitivity reaction while grades 2 and 3 constitute anaphylaxis. The management of anaphylaxis involves stopping the precipitant, administering epinephrine IM, antihistamines, steroids, IV fluids, and monitoring for 2-3 days. Factors that can increase severity include age, allergen type, atopy, cardiovascular disease, asthma, and delayed epinephrine administration.

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    of 4

    Grading system for generalised hypersensitivity /

    anaphylaxis
    ( Brown SGA . Clinical features and severity grading 0f anaphylaxis
    J. Allergy Clin Immunol 2004, 114(2) : 371-6 )
    1.Mild (involvement of the skin-mucosal tissues) :
    generalised erythema , urtica, periorbital edema or
    angioedema
    2.Moderate (involvment of Respiratory, Cardiovascular, GI syst) :
    SOB, Stridor, wheezing, nausea, vomiting, dizziness
    (presyncope),diaphoresis, chest / throat tightness, abd. pain /
    abd. cramp
    3.Severe (hypoxia, hypotention, neurological compromise) :
    cyanosis(SpO2 92%), hypotention(adults ;SBP <
    90 mmHg),

    confusion, collapse, LOC / Loss of

    Consciousness,
    incontinence.
    (1 = acute hypersensitivity reaction)

    (2 & 3 = anaphylaxis)

    Management acute hypersensitivity / anaphylaxis


    Acute hypersensitivity reaction
    (involvement of the skin, mucosal
    tissues, or both only)
    Dipenhydramine inj (10-20 mg) IM
    Observation for 4-6 hours
    Good
    Response
    (no clinical
    manifestation)
    Ambulatory

    Oral
    antihistamin
    e for 3 days

    No
    response

    Anaphylaxis reaction
    (involvement of 2 or more system /
    organ)
    Management of anaphylaxis

    Observation
    No Response
    (be worsen)

    worsening

    Explore the
    prognostic factors
    In patient

    Another treatment
    (due to the
    problem)

    IVFD
    AH1 inj i.m
    AH2 inj i.v
    Steroid inj

    Good Response

    No Response
    (be worsen)

    MANAGEMENT OF ANAPHYLAXIS
    History of severe allergic reaction with respiratory difficulty or
    hypotension, especially if skin changes present
    Stop administration of precipitant
    Oxygen high flow
    Adrenalin / epinephrine (1 : 1000) 0,3 0,5 ml IM (0,01 mg/kg BW)
    Repeat in 5-15 minutes if no clinical improvement
    Antihistamine 10-20 mg IM or slowly Intravenously
    In addition
    Give 1-2 l of fluid intravenously if clinical manifestation of shock do not respond
    to drug treatment
    Corticosteroid for all severe or recurrent reactions & patients with asthma.
    - Methyl prednisolone 125-250 mg IV
    - Dexamethasone 20 mg IV
    - Hydrocortisone 100-500 mg IV slowly
    continue by maintenance dose
    Inhaled short acting -2 agonist may used if bronchospasm severe
    Vasopressor (dopamine, dobutamine) with titration dose
    Observation for 2 - 3 x 24 horus, for mild case just need 6 hours
    Give Corticosteroid and antihistamine orally for 3 x 24 horus
    Elderly ( 60 y.o), CVD adrenalin dose 0,1-0,2cc IM with interval 5-10 mnt

    FACTORS ASSOCIATED WITH


    SEVERITY REACTIONS

    Age

    Allergen

    Atopy

    CVD (Cardiovascular Disease)

    COPD (Chronic Obstructive Pulmonary Disease)

    Asthma Bronchiale

    Acid base and electrolyte inbalance

    Drugs ( eg, beta-blocker, ACE-inhibitor)

    Interval of epinephrine injection after exposure

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