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18 Cards in this Set
- Front
- Back
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What is latex?
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natural rubber protein
from hevea brasiliensis tree |
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Incidence of latex allergy
general population peds population healthcare workers |
general 1-6%
pedi 73% Health 8-17% anesthesia 15% |
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Assoc. allergies
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avocados, kiwi, banana, fig, chestnut, fig, hazelnut, sweet peper, melon, pineapple, papaya, seasonal rhinitis, asthma
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What types of rxn can contact dermatitis be?
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1. type IV sensitivity
(mimics poison ivy) 2. Anaphylactic IgE mediated (type I) |
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How does anaphylaxis occur
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previous exposure
B cells produce IgE antibodies antibodies bind to receptors on mast cells and basophils re-exposure causes antigen to activate effector cells and release histamine, leukotrienes, prostaglandins, and kinins |
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is anaphylactoid IgE mediated?
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nope
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what agents are implicated in anaphylaxis in anesthesia?
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ABX
LA insulin latex |
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What agents are implicated in anaphylactoid rxn in anesthesia?
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NMB
opioids hypnotics protamine colloids steriods vancomycin NSAIDS |
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Histamine
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vasodilation
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prostaglandin
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bronchoconstriction, vasodilation
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leukotrienes
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edema
vasodilation |
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proteoglycans
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coag cascade --> DIC
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proteases
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bronchoconstriction
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What is the hallmark clinical feature of CV compromise of anaphylaxis?
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hypotension
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What is the initial treatment plan for anaphylaxis?
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1. Stop admin
2. airway mngt 3. 100% O2 4. d/c all anesthetic agents 5. rapid volume expansion 6. EPI 5-10 mcg IV, titrate 7. EPI 0.1-1.0 mg IV |
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What is the secondary treatment plan for anaphylaxis?
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1. antihistamines (.5-1mg/kg diphenhydramine)
2. catecholamines 3. aminophylline 4. corticosteriods 5. Sod Bicarb 6. airway eval prior to extubation |
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AANA latex protocol for pt's at high risk
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1. 1st case
2. OR "latex free" signs 3. remove latex from OR 4. bring cart into OR (latex free) 5. wrap cords in stockinette 6. use non latex! 7. inject thru stopcocks |
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following anaphylaxis where does the pt go?
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to ICU for 24 hr
may reoccur s/s may last up to 32 hrs |
