Management of Allergic Reactions and Anaphylaxis in the Emergency Department (Pharmacology CME)

Management of Allergic Reactions and Anaphylaxis in the Emergency Department (Pharmacology CME) is organized by EB Medicine.

About This Issue:
A patient with an allergic reaction can present with symptoms ranging from mild rash, to gastrointestinal complaints, to complete respiratory collapse. Predicting which patients are likely to suffer moderate to severe allergic and/or anaphylactic reactions can be difficult, though noting history and risk factors for severity will dictate treatment plans. In this issue, you will review:
• How the diagnosis of anaphylaxis and allergic reactions are defined and graded by criteria from national and international organizations.
• The ways augmenting factors, concomitant diseases, and co-factors can increase or worsen allergic reactions.
• The prevalence of certain anaphylaxis signs and symptoms of skin, respiratory, gastrointestinal, cardiovascular, and neurologic systems.
• The latest evidence on administering epinephrine: dosage, routes, and monitoring, including special cautions on intravenous dosing.
• Fluids, corticosteroids, antihistamines: is there any evidence they are helpful?
• Unusual types of reactions to watch for: alpha-gal (tick-borne) allergy, scombroid poisoning, and Kounis syndrome.
• The risk factors for biphasic anaphylactic reaction and whether observation can help reduce risk.
• Disposition recommendations for mild, moderate, and severe anaphylaxis as well as nonanaphylactic reactions.

CME Objectives:
Upon completion of this activity, you should be able to:
• List the most common triggers of allergic reactions and anaphylaxis and describe the pathophysiology
• Identify and differentiate allergic reactions and anaphylaxis
• Manage allergic reactions of all severities and provide safe disposition for patients.