Lecture

• Main reason PEA occurs is bcuz of hypoxia
• You can't TOR a PEA bcuz there's usually a correctable cause
• Angioedema is prioritized like FBAO or any other primary airway obstruction
• If cardiac arrest occurs due to anaphylaxis, you can give EPI but only 1 dose max
• Reperfusion arrythmias occur after ROSC and due to ischemia, weird rhythms occur
• ACPs can administer dopamine to cause ionotropic effects in a ROSC
• As a general rule, paramedics do not count pre-arrival care; it can be documented but it doesn't really affect your treatment as much
• Early transport for medical arrests: pregnancy over 20 weeks, hypothermia, FBAO, non-opioid drug OD and other reversible causes
• Universal sign for allergic rxn is pruritus or itching
• Allergens enter the body via: ingestion, injection, inhalation and absorption
• Inflammation may cause plaque to break off of arteries which may cause an AMI which is an example of how an anaphylactic rxn may lead to cardiac arrest
• Paramedics are only allowed to treat moderate to severe allergic reactions
• Histamine causes cell membranes to destabilize and leak fluids
• Mild allergic rxns has no involve of any other body system besides skin
• A moderate allergic rxn consists of a systemic reaction but it doesn't have hypotension, respiratory involvement and alterations of LOC
• Laryngeal edema can cause stridor
• Moderate allergic reactions usually involve the integumentary and GI systems
• If you treat with EPI, follow up with diphenhydramine shortly after
• Diphenhydramine is both an antihistamine and anticholinergic drug
• After 2 doses of EPI, you could patch to give more if anaphylaxis is refractory
• For Diphenhydramine, the dose is 25mg for PTs between 25-50 kg and then 50mg for anyone over 50kg
• Diphenhydramine has a 1 max of only 1 dose and can be given IV/IM
• EPI can only be given in anaphylaxis thru the IM route
• Urticaria blanches when its pressed on; way to differentiate from eczema