the ability of the body to resist certain types of organisms or toxins
Define Acquired Immunity
occurs after the body has been exposed to a substance (an antigen) that triggers the immunity
a protein that protects against antigens by direct attack on the antigen, and activation of other systems that also attack the antigen
Define Allergic Reaction
an exaggerated response to the presence of antigens
a severe allergic reaction to the presence of antigens that affects 2 or more systems; histamine and heparin are released into the bloodstream
Define Anaphylactic Shock
a severe allergic reaction to the presence of antigens that affects 2 or more systems that causes hypoperfusion
What is happening in the body in a state of anaphylaxis
spasms of smooth muscles of bronchioles causing SOB
histamine is released and causes the capillaries to become permeable and leak fluid causing urticaria (hives)
angioedema: swelling of the mouth/oropharynx, possibly leading to the tongue and lips
nausea, vomiting, abdominal cramps and diarrhea are common
What are the systems involved in anaphylaxis?
What is the treatment for anaphylaxis?
What does epinephrine do to the body?
vasoconstricts (increasing BP) and bronchodilates (opening the airway)
an increase in blood flow to the area of exposure from heparin and histamine ( which causes an increase of the plasma leakage out of capillaries and causing urticaria, swelling, tachycardia, and hypotension)
the rapid swelling of the dermis, subcutaneous tissue, mucosa and submucosal tissues (mouth, lips, tongue, oropharynx)
What are the respiratory affects of anaphylaxis?
excessive mucus production/plugging (wheezing)
airway swelling (pharynx, tongue, epiglittis)
What is the dosage for Epinephrine?
Adult = 0.3 mg (for someone over 30kg/66lbs)
Child = 0.15 mg (for someone under 30kg/66lbs)
What are the ALS upgrades for an allergic reaction?
Pt is presenting w/ signs and/or symptoms of an anaphylactic reaction within 1 hour of exposure to an allergen AND has a history of anaphylactic reaction to this allergen
difficulty swallowing or swelling in throat, lips or tongue
severe adbominal cramps, nausea, vomiting or diarrhea with urticaria or flushing
any use of epinephrine requires an ALS upgrade
If the patient is asthmatic, and has a BP of at least ____ and is still SOB after the administration of epinephrine, assist with patient's albuterol.
What class of drug is epinephrine?
What are the indications for the administration of epinephrine?
patient is displaying s/s of anaphylaxis OR shock OR difficulty swallowing (throat edema) and consents to treatment
What are the adverse reactions/precautions for the use of epinephrine?
may cause cardiac ischemia in the elderly or in pts with known coronary artery disease
What are the pertinent subjective findings in a patient with an allergic reaction? (protocol)
previous allergic reaction and severity
recent exposure to possible allergens
prescription for epi-pen
What are the pertinent objective findings in a patient with an allergic reaction? (protocol)
cyanosis or pallor
swelling of face, pharynx, or tongue
medic alert tag
weak, rapid pulse
What are the steps for the administration of an Epi-pen?
Place auto injector on pt's lateral thigh and push firmly against the site. hold for 10 seconds minimum
dispose of injector in sharps container
record time of injection
reassess in 2 minutes
contact ALS for additional doses of epinephrine
treat for shock as necessary
turn in MIR to Medic One and pick up Epi-pen replacement
What are the three things you should check on the epi-pen itself before administering?
that it is not cloudy
always use our epi-pens, not the patients
What are the 4 ways that poison can enter the body?
What is the number for poison control?
What are the ALS upgrades for overdose/poisoning (toxic exposure)?
Polypharmacy (use of multiple meds)
Overdose of Tylenol, ASA or iron
Intentional overdose with prescription meds
Seizure without history
On recommendation of WA poison center
Patient with impaired gag reflex
What does SLUDGE stand for?
Lacrimation (watery eyes)
What are the pertinent subjective findings in an overdose/poisoning (toxic exposure)?
substance exposed to
time, route, duration, concentration/dose of exposure
number of ppl exposed (consider WMD)
history of mental illness
are weapons present or accessible?
What are pertinent objective findings in an overdose/toxic poisoning (toxic poison)?
empty containers/pill bottles
s/s of ACS
gag reflex (present/absent)
What class of drug is activated charcoal?
What is another name for activated charcoal?
What are the indications for the use of activated charcoal?
treatment of patient who has ingested poisons by mouth, when recommended by the Washington Poison Control
What are the contraindications of the use of activated charcoal?
relative (without GI tube): absent gag, unconscious patient, potential sedation from suspected overdose
What are the precautions/adverse reactions to activated charcoal?
does not absorb iron, lithium, inorganic ions, ethanol, methanol, or cyanide
What is the suggested dosage for activated charcoal?