RESUSCITATION, CARDIOPULMONARY (CPR)

Resuscitation Council UK has a full range of Guidelines for child and adult resuscitation available. The underlying principles are to assess the ABCDEs:

• Airway
• Breathing
• Circulation
• Disability (loss of consciousness)
• Exposure/examination

ANAPHYLAXIS

A severe systemic allergic reaction – patients have life-threatening airway and/or breathing and/or circulation problems, usually + skin and mucosal changes. In susceptible individuals can be triggered by foods (eg, peanut, shellfish), or wasp or bee stings, and may occur following an injection or IUD insertion.

Treatment

Early IM injection with iadrenaline is the treatment of choice. Give adrenaline IM at midpoint of anterolateral thigh. Repeat after 5 mins if condition not improved or getting worse. ALWAYS FOLLOW LATEST GUIDANCE.

Adrenaline dosage for anaphylaxis is:

• Adult or child >12 years: 0.5 ml of 1:1000 solution (500 micrograms)
• Child 6–12 years: 0.3 ml of 1:1000 solution (300 micrograms)
• Child

NB Adrenaline has a short shelf-life Individuals known to be at high risk, e.g. with peanut allergy, should carry an adrenaline auto-injector (Anapen or Epipen) and be trained how to use it. The latest advice from the MHRA is that patients (or their carers) who carry an adrenaline auto-injector are recommended to carry two devices. In addition, an ambulance should be called after administration, even if their condition seems to be improving. If possible, the patient should not be left alone. If symptoms are not improving, a second dose should be administered 5 - 15 minutes after the first.