PSA: Patients with anaphylactic reactions...

[MIcrunchyRN]

So I learned this the hard way through personal experience this week...

When your patient is either leaving the ER or the floor because they were there for a severe allergic reaction or anaphylactic reaction...

Make sure they go home on antihistamines and steroids for at least a week! If doc doesn't send them home on any... QUESTION IT!!

LOL I had an anaphylactic reaction and was sent home without steroids or antihistamines. I had no idea I could have what is called a "biphasic reaction" which can occur within ours of the reaction or as long as a full week later. I went into ER again (2 days later) and was diagnosed as having "anxiety" altho nurse couldn't figure out why they didn't send me home on anything he missed that anxiety is a sign of an allergic reaction.

I ended up going to doc a few hours after leaving ER... wheezing having a 2nd reaction. Which could have been prevented had they kept me on meds!

Anyways I just wanted to share... if you know and questions yourself your probably right go double check with doc! Because for me my 2nd reaction was a very long onset, it wasn't until I was wheezy that someone took me serious and apparently the 2nd reaction is fairly common.

[leslie :-D]

wow, thank you for this tidbit!

i'm posting a link about anaphylaxis, since it is a common and serious occurrence.

i'm glad you're ok now, mi.

Anaphylaxis

http://www.emedicine.com/med/topic128.htm

scroll down to "Further Outpatient Care" re need for continuing steroids, antihistamine.

leslie

[nrsang97, BSN, RN]

I have never been sent home after allergic reaction without steroids and antihistamines. Strange.

Hope you are OK and never experience that again.

[MIcrunchyRN]

Leslie- Thank you for posting that link! I was just about to post one.

Under Clinical Care

http://en.wikipedia.org/wiki/Anaphylaxis

I had my nurse question me about why I didn't get sent home with them and I said I thought they didn't because I had been in hospital for 2 days and had no reoccurance. He seemed confused but didn't say anything. Turns out he WAS right... (I was kept inpatient because of tachycardia that wouldn't go away, they think epi didn't get into muscle correctly and was sub q and thus took longer to cycle thru)

Anyways thank you!

[kmoonshine, RN]

If we send a patient home who had anaphalaxis, they go home with prescriptions for benadryl, pepcid, prednisone, and an epi-pen.

For serious anaphalactic reactions we give epi sub-q, although I've seen it given once using IV route for someone whose throat was closing up right before our eyes...

[MIcrunchyRN]

If we send a patient home who had anaphalaxis, they go home with prescriptions for benadryl, pepcid, prednisone, and an epi-pen.

...

lol why does everyone else know to do that but the ER i was in? Woudl have saved me a load of time and $$

Anyways just wanted to bump this up one last time so more people can view it

[mpccrn, BSN, RN]

hmmm perhaps this is more a "on an individual basis". i had an anaphalactic reaction, required several doses of epi and benadry, went home on nothing and was fine

[MIcrunchyRN]

hmmm perhaps this is more a "on an individual basis". i had an anaphalactic reaction, required several doses of epi and benadry, went home on nothing and was fine

because you had your biphasic reaction in hospital if you required multiple doses. But they cannot predict who will get a 2nd reaction nor when so as prophylaxis should be on them at discharge to prevent a reaction when they get home.

[vampiregirl, BSN, RN]

In regards to antihistamines for allergic reactions, use caution with "caplets" (Benadryl for example). They don't dissolve very quickly sometimes. I had taken some for an allergic reaction a couple of years ago and didn't get any relief, even after 20 minutes. Ended up in the ER, and the doctor later figured out that this probably was the difference. I did some research and discovered that the liquids and capsules are what is recommended for an allergic reaction.

[chenoaspirit, ASN, RN]

So is the Epi sub-q or IM for allergic reactions?

[joannep]

So is the Epi sub-q or IM for allergic reactions?

Hi,

The Epi pen is an intramuscular injection. This is a link to prescribing information & patient package insert which contain administration instructions.

http://www.anaphylaxis.com/pro/6_6_7.cfm