A Resuscitation Room Guide Banerjee by Hargreaves

By Hargreaves

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The advantage of a biphasic shock is that defibrillation is achieved with lower energy delivery, resulting in less myocardial damage. 85 45 46 46 47 Fig. 10 (a) Monophasic: damped sinusoidal (sine wave) (gradual return to zero current flow or truncated with exponential decay (abrupt return to zero current flow): current in the positive direction only. (b) Biphasic (bi-directional) sinusoidal: reversal of the current polarity midway through the discharge gives both positive and negative current.

Uk) or a wallet card • Serum sample for mast cell tryptase may be useful in obscure anaphylactic reactions to confirm the diagnosis retrospectively; this is an investigation only available in tertiary referral centres. Ten mL of clotted blood is sent to the reference laboratory. 5ng/mL • Avoid non-cardiac-selective beta-blockers, which may impair the effectiveness of epinephrine by antagonizing its beta-agonist activity • Consider notifying the Medicines and Health Care Products Regulatory Agency (MHRA) • Consider follow-up by a specialist in allergy/clinical immunology.

Common causes • Foods: peanuts; tree nuts; strawberries; fish; shellfish; eggs; milk • Insect stings: bees; wasps • Drugs: antibiotics (penicillin); aspirin; non-steroidal anti-inflammatory drugs (NSAIDs); intravenous anaesthetics and muscle relaxants; opioid analgesics; radiographic contrast media • Vaccines • Latex rubber. Features • A rapid onset of symptoms • Laryngeal oedema, laryngospasm and bronchospasm; stridor (upper and/or lower airway obstruction) • Cardiovascular collapse: profound hypotension and marked tachycardia • Skin signs: redness, intense itching, urticaria, angioedema of the face and oral mucosa • Nausea, vomiting, diarrhoea and abdominal pain • Reduced level of consciousness • Diagnostic problems arise from a lack of consistent clinical manifestations, and varying combinations of the listed features can occur.

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