Anaphylactic Ana — Anaphylaxis
Airway closing — epinephrine IM, thigh, now
Ana gets ten minutes into her first dose of IV penicillin when her lips start to swell and her voice changes. The whole story happens in the time it takes to walk down a hallway.
Ana's immune system overreacts within minutes of an antibiotic dose: hives, swelling lips, stridor, wheezing and a plummeting blood pressure. Epinephrine intramuscularly into the vastus lateralis comes first — antihistamines and steroids are adjuncts, never the first move.
Read Anaphylactic Ana's full story →The story arc
The setup
A first dose of IV penicillin starts infusing; Ana mentions she has never taken it before.
The turn
She scratches at hives on her chest, then says her tongue feels thick.
The crisis
Stridor, wheezing, blood pressure 82/40, heart rate 130.
The save
The infusion is stopped, IM epinephrine goes into her thigh, oxygen and fluids follow, then diphenhydramine and methylprednisolone.
NCLEX study section — Anaphylaxis
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Pharmacology
Take this chapter into practice questions on the same topic.