Field treatment of anaphylactic shock includes:
1. Medications, including epinephrine, diphenhydramine, dopamine and dosed fluid boluses;
2. Supplemental oxygen; and
3. Airway support.
The effects of the treatment often lead to the three following outcomes:
1. Signs and symptoms are sometimes mild enough and recognized early enough, and they often fade when self-treated;
2. Signs and symptoms don’t subsequently recur from this type of exposure; and
3. Treatment is rendered, and improvement of the signs and symptoms is seen; however, symptoms may recur in four to 12 hours. This late phase reaction requires further treatment and close observation, and it can occur in about 10% of the cases. About 20% of anaphylactic reactions are severe enough and persistent enough to require intense EMS treatment and hospitalization. Let’s take a look at a few more cases.
Rick Rod, RN, CEN, NREMT-P, is currently the paramedic field training coordinator and clinical educator for San Diego EMS- Rural/Metro of San Diego and San Diego Fire-Rescue Department