Management of severe anaphylaxis in the emergency department

A brief review of the management of the critically ill patient with anaphylaxis in the emergency department

Case

A 31 year old female is brought into the emergency department by ambulance after she collapsed at a family birthday party. She has a diffuse red rash, a blood pressure of 80/40, and an oxygen saturation of 88% on room air. She is wearing a medicalert bracelet. Her uncle guiltily admitted to EMS that he hadn’t told people that the vegan “cheese ball” he brought was actually just pureed nuts…

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Undifferentiated hypotension

A simplified approach to the initial assessment and management of patients presenting to the emergency department with undifferentiated hypotension and shock

Case

“Doctor to resus 2, stat”, and you just stepped into the department. There hasn’t even been time for a sip of coffee or a washroom break after the commute in. In the resus room, you are greeted with a hub of activity – nurses, paramedics, and medical students everywhere – surrounding a 50 something male, rather grey in colour, with a blood pressure of 63/37…


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