Hot Pepper Anaphylaxis

As an FYI and a point of interest...

We recently had a 34 y.o male who presented to our ED with swollen lips and feeling like he had airway closure. He quickly progressed to full anaphylaxis which was not reversable with the standard epi/steriods. This went out and he then became quickly bronchospastic. Unintubatable and a real nightmare. One of our ICU guys gave him KETAMINE. I guess he had read this somewhere at some point in time and it hit him in the middle of this disaster (his favorite expression is 'i'd rather be lucky than good'). Anyhow, the patient gets ketamine and intubation bronchospasm subsides and I think it is worth passing along as something to keep in mind if this ever happens in your ED. I am not sure how frequent a hot pepper allergy is (this was the causitvie ingestant) but i think it is worth mentioning as food for thought (no pun intended).

[gwenith, BSN, RN]

We used to use Ketamine for unreversable Status Asthmaticus in the days before and many rural doctors who do not have the access to advanced equipment will still try this.

[KKERRN]

Thanks for sharing your food for thought! This has happened in our ER...yet.

How long did it take for bronchospasms to resolve?

[EastCoast]

My colleagues reported this whole incident was approximately 2+ hours. I will also add that I think our intensivist is top notch in educaiton and practice and he was having a difficult time with airway management. Gwenith, interesting we used a rural back up plan in our busy metro ED and everyone thought it must be the most 'current' technology. i am going to be sure to pass this on to my intensivist. thanks.!!

[teeituptom, BSN, RN]

Saw that secondary to a person being pepper sprayed by the police.

Ketamine works wonderfully for that and astma also.

cool stuff

[renerian, BSN, RN]

Wow I never thought about a pepper spray allergy! Wow. Ketamine is a hot street drug too. Stolen alot.

renerian

[EastCoast]

speaking of police. how about the cop that sprayed a combative patient in our ED and it needed to be evacuated. the guy was handcuffed ot a stretcher already.

[Erin RN]

Sounds like not a very intelligent police officer...LOL

[KKERRN]

We had a security officer spray someone unnecessarily...had to evacuate the ER and fire dept hooked up fans to blow the bad air out the doors!! What a night that was.