10. …and it was a quiet day on the MV Pacific
Carnival Princess Cruise Liner…
11. …and it was a quiet day on the MV Pacific
Carnival Princess Cruise Liner…
A – no stridor, able to talk
B – no wheeze, sats 100%
RR 14
C – PR 100
BP 140/100
Would you give her adrenaline?
17. ERC Resuscitation 2010
hypersensitivity reaction
severe, life-threatening
generalised or systemic
may have skin and mucosal changes
European Resuscitation Council Guidelines for Resuscitation 2010. Resuscitation 81 (2010) 1219–1276
36. The Journal of Emergency Medicine, Vol. 42, No. 5, pp. 612–620, 2012
37. Β-lactam
R
ring
≈ side chain
The Journal of Emergency Medicine, Vol. 42, No. 5,
pp. 612–620, 2012
38.
Penicillin allergic patients
more allergic to EVERYTHING
Until mid-1980s
penicillins and cephalorsporins made
using the same mold
The Journal of Emergency Medicine, Vol. 42, No. 5,
pp. 612–620, 2012
39.
Cross reactivity:
1% who state penicillin allergy
2% with confirmed penicillin allergy
1st and 2nd generation only
The Journal of Emergency Medicine, Vol. 42, No. 5,
pp. 612–620, 2012
41. Cephalosporins and Penicillin
Negligible Cross-reactivity
MOST 1st and 2nd generation
(cefaclor, cefalexin etc)
and
ALL 3rd and 4th generation
(ceftriaxone)
56. References and
Acknowledgements
Brown A. Current management of anaphylaxis. Emergencias 2009; 21: 213-223.
Campagna JD, Bond MC, Schabelman E, Hayes BD. The use of cephalosprins in
penicillin allergic patients: a literature review. Journal of Emergency Medicine 2012.
42(5); 612–620.
deShazo R. Anaphylaxis: My “Top 10′′ List. Southern Medical Journal 2007: 100(3),
233234.
Dewachter P, Mouton-Faivre C, Emala CW. Anaphylaxis and Anesthesia,
Controversies and New Insights. Anesthesiology 2009; 111:1141–50.
Worth A, Soar J, Sheikh A. Management of anaphylaxis in the emergency setting.
Expert Rev. Clin. Immunol; 2010. 6(1), 89–100.
Not sponsored by Epipen nor Zovirax nor Seasame Street
Thanks to Stephen Odgers (backing vocals and guitar) and Jim Henson