10:50
EMT Medical Assessment: Allergic Reaction
Summit Medical Academy
Overview
This video demonstrates the medical assessment and initial treatment of a patient experiencing anaphylaxis, likely due to a bee sting. It covers the initial impression, primary assessment focusing on airway, breathing, and circulation (ABC), and the administration of oxygen and epinephrine. The video emphasizes the importance of a rapid assessment and transport for patients with potential airway compromise, highlighting the patient's improvement after treatment and the ongoing reassessment process during transport.
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Chapters
- The patient, a male in his 20s, presented with shortness of breath and difficulty breathing after a suspected bee sting.
- He was found in a tripod position, indicating respiratory distress.
- Initial assessment revealed he was alert and oriented but speaking in short phrases, suggesting potential airway issues.
- The paramedic's general impression was an allergic reaction or anaphylaxis.
Establishing a rapid general impression helps the EMS provider quickly identify life threats and prioritize subsequent assessments and interventions.
The patient was found sitting on a park bench in a tripod position, struggling to speak in more than two to three words.
- Airway assessment included checking for tongue swelling, throat redness, hoarseness, and cough, all indicators of potential airway compromise.
- Breathing assessment involved listening for stridor (inspiratory wheezing) in the throat and auscultating lung sounds for wheezing or diminished sounds.
- Circulation assessment focused on skin color, temperature, and condition, noting the presence of urticaria (hives) on the patient's neck and arms.
- Oxygen was administered via a non-rebreather mask to address hypoxia.
A systematic primary assessment of ABCs is crucial for identifying and managing immediate life threats in a patient with suspected anaphylaxis, as airway swelling can rapidly progress.
The paramedic looked inside the patient's mouth for swelling and listened to his throat for stridor and his lungs for wheezing.
- A focused history was obtained, including the mechanism of injury (bee sting), onset of symptoms, allergies (bee allergy confirmed), and pertinent medical history.
- The patient confirmed a sharp pain on his arm, followed by shortness of breath within minutes.
- The diagnosis of an anaphylactic reaction was made based on the history and presenting signs and symptoms.
Gathering a focused history helps confirm the suspected diagnosis and rule out other potential causes of the patient's symptoms, guiding appropriate treatment.
The patient reported feeling a sharp pain on his arm from a bee sting, followed by shortness of breath about a minute or two later.
- The primary treatment for anaphylaxis, epinephrine, was administered intramuscularly (IM).
- The patient was identified as a 'load and go' situation due to the threat to his ABCs, necessitating rapid transport to the hospital.
- Vital signs were obtained, including heart rate, blood pressure, and oxygen saturation (SpO2).
Prompt administration of epinephrine is critical for reversing the effects of anaphylaxis, and rapid transport is essential for definitive care.
Epinephrine was administered via an auto-injector to the outside of the patient's leg.
- After epinephrine administration, the patient showed improvement, speaking in fuller sentences and reporting feeling better.
- Ongoing reassessment during transport is vital, monitoring for changes in airway swelling, stridor, lung sounds, and vital signs.
- Consideration for redosing epinephrine based on local protocols and patient condition.
- A radio report was given to the receiving hospital detailing the patient's condition, interventions, and vital signs.
Continuous reassessment ensures that the patient's condition is monitored closely during transport, allowing for timely adjustments to treatment and preparing the receiving facility.
The radio report included the patient's initial vital signs (HR 130, BP 80/40, SpO2 85%) and improved vital signs after treatment (HR 100, BP 110/86, SpO2 95%).
Key takeaways
- Anaphylaxis is a life-threatening allergic reaction that requires rapid assessment and intervention.
- The primary assessment of Airway, Breathing, and Circulation (ABC) is paramount in patients with suspected anaphylaxis.
- Signs of airway compromise in anaphylaxis include tongue swelling, hoarseness, stridor, and difficulty breathing.
- Epinephrine is the first-line treatment for anaphylaxis and should be administered promptly.
- Patients with anaphylaxis are often 'load and go' situations requiring immediate transport to definitive care.
- Continuous reassessment of the patient's condition during transport is critical for managing potential deterioration.
- A thorough, focused history is essential to confirm the diagnosis and guide treatment.
Key terms
AnaphylaxisAllergic ReactionTripod PositionDyspneaStridorWheezingUrticariaAngioedemaEpinephrineIntramuscular (IM)Vital SignsSpO2
Test your understanding
- What are the key components of a primary assessment for a patient with suspected anaphylaxis?
- Why is prompt administration of epinephrine crucial in managing anaphylaxis?
- How can EMS providers assess for potential airway compromise in a patient experiencing an allergic reaction?
- What information should be included in a radio report for a patient with anaphylaxis being transported to the hospital?
- Why is continuous reassessment of a patient with anaphylaxis important during transport?