Angioedema

Ahhhhhh angioedema, want to watch a bunch of people run in circles panicking?? Send them a pt with ace-inhibitor induced angioedema.

Grab some popcorn and sit back, as they panic more when "nothing is working"

From my experience when a patient presents with this and they are not complaining of any breathing difficulty and it does not appear to be an allergic reaction and they have been taking an ace-inhibitor our docs will do the benadryl and steroid (sometimes epi) more so to feel like they did something *also usually if in a place working with ED residents and off service residents* since it never works. I have seen FFP used and it helped. But pretty much it was a waiting game and monitoring to make sure the airway wasn't compromised. A lot of experienced docs I worked with that experienced this often would simply do the latter.

The last angioedema patient I had got a concoction of solu-medrol, Benadryl, and Pepcid to start off with and then a few days of Benadryl and prednisone. No epi needed. Spent a night in the OBS unit to monitor for airway swelling and then discharged the next day.

Ahhhhhh angioedema, want to watch a bunch of people run in circles panicking?? Send them a pt with ace-inhibitor induced angioedema.

Grab some popcorn and sit back, as they panic more when "nothing is working"

From my experience when a patient presents with this and they are not complaining of any breathing difficulty and it does not appear to be an allergic reaction and they have been taking an ace-inhibitor our docs will do the benadryl and steroid (sometimes epi) more so to feel like they did something *also usually if in a place working with ED residents and off service residents* since it never works. I have seen FFP used and it helped. But pretty much it was a waiting game and monitoring to make sure the airway wasn't compromised. A lot of experienced docs I worked with that experienced this often would simply do the latter.

Yup-

Have seen the same.

I think part of the rationale is that maybe it is actually an allergic reaction, and risk/benefit favors treating it as such.

But, in ACE inhibitor induced angioedema, treating for an allergic reaction is about as effective as applying a knee brace.