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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 21

Allergy and Anaphylaxis

Learning objectives (11)

  1. Define the terms allergic reaction and anaphylaxis — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  2. Demonstrate how to remove the stinger from a honeybee sting and proper patient management following its removal — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  3. Describe some age-related contraindications to using epinephrine to treat an allergic reaction in a geriatric patient — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  4. Differentiate the primary assessment for a patient with a systemic allergic or anaphylactic reaction and with a local reaction — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  5. Discuss the steps in the primary assessment that are specific to a patient who is having an allergic reaction — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  6. Explain the difference between a local response and a systemic response to allergens — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  7. Explain the factors involved when making a transport decision for a patient having an allergic reaction — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  8. Explain the importance of managing the ABCs of a patient who is having an allergic reaction — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  9. Explain the rationale, including communication and documentation considerations, when determining whether to administer epinephrine to a patient who is having an allergic reaction — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  10. List the five categories of stimuli that could cause an allergic reaction or an extreme allergic reaction — Knowledge/skills objective (printed page 803); confirm wording in your course copy.
  11. Review the process for providing emergency medical care to a patient who is experiencing an allergic reaction — Knowledge/skills objective (printed page 803); confirm wording in your course copy.

Vocabulary (11)

Allergen
A substance that triggers an immune (hypersensitivity) response — common examples include foods, insect venom, latex, and medications.
Allergic reaction
An adverse immune response to an allergen, ranging from mild itching to life-threatening anaphylaxis.
Anaphylaxis
A severe, rapidly developing systemic allergic reaction with airway, breathing, or circulatory compromise.
Urticaria (hives)
Raised, itchy, often blanching wheals on the skin caused by histamine release.
Angioedema
Swelling of deeper skin and mucous membrane tissues — face, lips, tongue — that can compromise the airway.
Bronchospasm
Constriction of bronchial smooth muscle that narrows the lower airways and produces wheezing.
Epinephrine
The first-line medication for anaphylaxis — a potent alpha- and beta-agonist that reverses bronchospasm, vasodilation, and edema.
Epinephrine auto-injector
A pre-filled, spring-loaded device delivering a single intramuscular dose of epinephrine — adult 0.3 mg, pediatric 0.15 mg.
IgE
The antibody class that binds allergens and mast cells to trigger immediate hypersensitivity reactions.
Mast cell
An immune cell that releases histamine and other mediators during allergic reactions.
Biphasic reaction
A recurrence of anaphylactic symptoms hours after the initial reaction has resolved, even without re-exposure.

Sequence practice (2 puzzles on Quiz Me)

Field treatment of anaphylaxis

Order EMT priorities when anaphylaxis is recognized.

  1. Recognize anaphylaxis — airway swelling, breathing difficulty, or shock plus allergen exposure
  2. Request ALS / call for additional resources
  3. Administer (or assist patient with) intramuscular epinephrine auto-injector
  4. Provide high-flow oxygen; assist ventilations as needed
  5. Position supine with legs elevated if hypotensive
  6. Reassess; prepare for a possible second dose and transport
Allergic reaction progression to anaphylaxis

Order these findings from earliest local reaction to full anaphylaxis.

  1. Local itching, redness, or hives
  2. Generalized urticaria and angioedema
  3. Wheezing or stridor
  4. Hypotension and altered mental status

Quick fire sample (11 of 11 on Quiz Me)

A substance that triggers an immune (hypersensitivity) response — common examples include foods, insect venom, latex, and medications.
  1. Allergic reaction
  2. Allergen
  3. Epinephrine
  4. Mast cell
An adverse immune response to an allergen, ranging from mild itching to life-threatening anaphylaxis.
  1. Urticaria (hives)
  2. Allergen
  3. Epinephrine
  4. Allergic reaction
A severe, rapidly developing systemic allergic reaction with airway, breathing, or circulatory compromise.
  1. Allergic reaction
  2. Anaphylaxis
  3. Epinephrine
  4. Biphasic reaction
Raised, itchy, often blanching wheals on the skin caused by histamine release.
  1. Urticaria (hives)
  2. Biphasic reaction
  3. Mast cell
  4. Epinephrine auto-injector
Swelling of deeper skin and mucous membrane tissues — face, lips, tongue — that can compromise the airway.
  1. Angioedema
  2. Biphasic reaction
  3. Epinephrine auto-injector
  4. Mast cell
Constriction of bronchial smooth muscle that narrows the lower airways and produces wheezing.
  1. Angioedema
  2. Bronchospasm
  3. Urticaria (hives)
  4. Biphasic reaction
The first-line medication for anaphylaxis — a potent alpha- and beta-agonist that reverses bronchospasm, vasodilation, and edema.
  1. Angioedema
  2. Epinephrine auto-injector
  3. Mast cell
  4. Epinephrine
A pre-filled, spring-loaded device delivering a single intramuscular dose of epinephrine — adult 0.3 mg, pediatric 0.15 mg.
  1. Anaphylaxis
  2. Mast cell
  3. Angioedema
  4. Epinephrine auto-injector
The antibody class that binds allergens and mast cells to trigger immediate hypersensitivity reactions.
  1. Epinephrine
  2. Mast cell
  3. Epinephrine auto-injector
  4. IgE
An immune cell that releases histamine and other mediators during allergic reactions.
  1. Epinephrine auto-injector
  2. Biphasic reaction
  3. Allergen
  4. Mast cell
A recurrence of anaphylactic symptoms hours after the initial reaction has resolved, even without re-exposure.
  1. Bronchospasm
  2. Mast cell
  3. Anaphylaxis
  4. Biphasic reaction

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/21/print/. Answers are not marked on this sheet.