Paramedic CAT (Critically Appraised Topic)
012 | Distributive Shock Secondary to Anaphylaxis
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Author
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Tyson Lehmann
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Date
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2020-08-02
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Reviewer
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Jennie Helmer
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Edited
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2020-10-22
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PICO Question
“Revisit and review individualized approach to anaphylaxis in the prehospital setting.”
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Population
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Adult and pediatric populations experiencing anaphylaxis
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Intervention
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Pharmacological interventions in distributive shock secondary to anaphylaxis
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Comparison
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Current practice and BCEHS Treatment/Clinical Practice Guidelines
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Outcome
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Review current approach to anaphylaxis and related interventions in the anaphylactic patient presentation
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Search Strategy
EBSCO Host
Clinical Bottom Line
Anaphylaxis is undertreated prehospitally in Canada. Maintain a clinical suspicion for anaphylaxis; particularly with a history of reaction and treat early with Epinephrine.
Search Outcome
PubMed collections: Results (Relevant)
- Brown JC, Simons E, Rudders SA. Epinephrine in the Management of Anaphylaxis. 2020. [LINK]
- Kimchi N, Clarke A, Moisan J, et al. Anaphylaxis cases presenting to primary care paramedics in Quebec. 2015. [LINK]
- Welsford M, Gupta R, Samoraj K, et al. Paramedic recognition and management of anaphylaxis in the prehospital setting. 2018. [LINK]
- Wood JP, Traub SJ, Lipinski C. Safety of epinephrine for anaphylaxis in the emergency setting. 2013. [LINK]
Relevant Papers
- Campbell R, Kelso JJ. Anaphylaxis: Emergency treatment. 2020 [cited 2017-02-01] [LINK]
Additional References
- Grabenhenrich LB, Dölle S, Ruëff F, et al. Epinephrine in Severe Allergic Reactions: The European Anaphylaxis Register. 2018. [LINK]
- Gupta RS, Warren CM, Smith BM, et al. Prevalence and Severity of Food Allergies Among US Adults. 2019. [LINK]
- Kounis NG, Soufras GD, Hahalis G. Anaphylactic Shock: Kounis Hypersensitivity-Associated Syndrome Seems to be the Primary Cause. 2013. [LINK]
- Kusniec F, Fischer G, Sela BA, et al. Magnesium protects against anaphylactic shock and cardiac myolysis in guinea-pigs. 1994.[LINK]
- Lee S, Bellolio MF, Hess EP, Erwin P, Murad MH, Campbell RL. Time of Onset and Predictors of Biphasic Anaphylactic Reactions: A Systematic Review and Meta-analysis. 2015. [LINK]
- Norris TL. Porth's pathophysiology: concepts of altered health states (10th ed). 2019. [LINK]
- McCance KL, Huether SE, Brashers VL, Rote NS. Pathophysiology: the biologic basis for disease in adults and children (8th ed). 2019. [LINK]
- Nawrocki PS, Poremba M, Lawner BJ. Push Dose Epinephrine Use in the Management of Hypotension During Critical Care Transport. 2020. [LINK]
- Nwaru BI, Dhami S, Sheikh A. Idiopathic Anaphylaxis. 2017. [LINK]
- Reber LL, Hernandez JD, Galli SJ. The pathophysiology of anaphylaxis. 2017. [LINK]
- Simons FE; World Allergy Organization. World Allergy Organization survey on global availability of essentials for the assessment and management of anaphylaxis by allergy-immunology specialists in health care settings. 2010. [LINK]
- Simons FE, Ardusso LR, Bilò MB, et al. World allergy organization guidelines for the assessment and management of anaphylaxis. 2011. [LINK]
- Soar J, Pumphrey R, Cant A, et al. Emergency treatment of anaphylactic reactions--guidelines for healthcare providers. 2008. [LINK]
- Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. 2020. [LINK]
- Turner PJ, Worm M, Ansotegui IJ, et al. Time to revisit the definition and clinical criteria for anaphylaxis? 2019. [LINK]