27
Volume3 Issue6
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S
upporting
Y
our
P
ractice
Manydrugs andmaterials commonlyused indental offices
can trigger allergic reactions—antibiotics, analgesics, local anesthetics, resins, etc. It is important to respond
promptly toany suspectedanaphylactic reactionas it candevelopquicklyandpotentiallybe fatal. If you suspect
apatientmight begoing intoanaphylactic shock, consider following theAnaphylaxis EmergencyPlandeveloped
by theCanadianSocietyof AllergyandClinical immunology (CSACI)
2
:
➊
➤
Administer epinephrineat thefirst signof a known
or suspectedanaphylactic reaction.
➋
➤
Call 911or your local emergency local services.
➌
➤
Administer a seconddoseof epinephrineafter 5 to
15minutes if the reactioncontinuesorworsens.
❹
➤
Transfer thepatient to thenearest hospital (ideallyby
ambulance), even if the symptoms aremildor have stopped.
➎
➤
Call thepatient’s emergencycontact person.
ManagementofAnaphylactoid
Reactions
Anaphylactoid reactionspresentwith the sameclinical
manifestations as anaphylactic reactions, but arenot causedby
an immunoglobulin-mediated response. Patientsmay therefore
experienceanaphylactoid reactionswithout prior sensitization
toanallergen. Anaphylactoid reactions aremanaged the same
wayas anaphylactic reactions.
Following InjectionofEpinephrine
It is recommended to raise the legsof aperson inanaphylactic
shock to improvebloodcirculation to theheart. CSACI urges
toavoid “havingan individual immediately sit upor standafter
receivingepinephrineas these suddenchangesof positionmay
lower their bloodpressure,worsen their condition, andpotentially
result indeath.”
2
If thepatient feels sickor is vomiting, place them
on their side.
Thecautionarymeasureof keeping thepatient ina lyingposition still applies after theemergencymedical team
has arrived. “Even if theperson is feeling ‘better’, they should
not
standuporwalk themselves to theambulance,”
stresses FoodAllergyCanada (formerlyAnaphylaxisCanada) on itswebsite.
3
Table1:
Signs andSymptoms of
Anaphylaxis
Skin system
hives, swelling (face, lips, tongue),
itching,warmth, redness
Respiratory
system
coughing,wheezing, shortness
of breath, chestpainor tightness,
throat tightness, hoarsevoice,
nasal congestionorhay fever-like
symptoms (runny, itchynoseand
wateryeyes, sneezing), trouble
swallowing
Gastrointestinal
system
nausea, painor cramps, vomiting,
diarrhea
Cardiovascular
system
paler thannormal skin colour/
blue colour,weakpulse, passing
out, dizzinessor lightheadedness,
shock
Other
anxiety, senseof doom, headache,
uterine cramps,metallic taste
Source: CanadianSocietyof AllergyandClinical Immunology. Anaphylaxis in
Schools&Other Settings. 3rdEdition. 2014.
ManagingMedical Emergencies:
Anaphylaxis
According toHealthCanada, an estimated600,000Canadiansmay be
affectedby life-threateningallergies.
1
Would youknowhow to recognize
the signs of—and respond to—anaphylaxis shoulda patient experience
it in your office?
Medical Emergencies
