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An Introduction to Assessing Airways
An Introduction to Assessing Airways
When someone is having an anaphylactic reaction the airway can swell, causing it to become narrower.
When air moves through the narrow airways it can cause a sound called a wheeze to be heard.
Listen to the person when they breathe, are there any new sounds? This is important and you will need to tell the people that arrive to help about the sounds the person is making.
Does the person feel like their airway is closing up?
Airway swelling (throat and tongue swelling causing difficulty in breathing or swallowing; patients may feel their throat is closing).
Hoarse voice.
Stridor (a high-pitched inspiratory noise caused by upper airway obstruction).
An Introduction to Assessing Breathing
An Introduction to Assessing Breathing
Does the person seem to be breathing more quickly than before?
Has their colour changed? Do they look blue around their mouth or lips?
If you cannot hear the person breathing anymore or if the movement of their chest has stopped, call 999) lie them down flat, start cardiopulmonary resuscitation as taught in your basic life support training.
Increased work of breathing.
Bronchospasm (wheeze) and/or persistent cough.
Patient becoming tired with the effort of breathing (fatigue).
Hypoxaemia (SpO2 <94%) which may cause confusion and/or central cyanosis.
Respiratory arrest.
An Introduction to Assessing Circulation
An Introduction to Assessing Circulation
When a severe allergic reaction happens, the blood vessels enlarge which causes blood to rush to the skin's surface. You may see their face, neck, arms or chest becoming red.
This increased blood flow to the skin means that the important organs such as the heart and brain receive less blood.
Is the person alert and responsive? Less blood to the heart and brain can cause the person to become drowsy or lose consciousness completely.
Do they have their eyes open? If they have their eyes closed do they open them when you speak to them? can they answer you when you talk to them?
If the person loses consciousness, lie them on their side or in the recovery position if you know how to do this.
Signs of shock:
pale, clammy
significant tachycardia (increased heart rate)
hypotension (low blood pressure)
Dizziness, decreased conscious level or loss of consciousness.
Arrhythmia.
Cardiac arrest.
An Introduction to Assessing Disability
An Introduction to Assessing Disability
In this case, disability is about whether the person is awake, can open their eyes and is able to communicate with you.
If they are awake and able to communicate, ask them if they feel anxious?
Many people who have anaphylactic reaction say they feel a sense that something bad is going to happen.
Some people will experience pain in their abdomen, nausea or sickness.
Dizziness.
Decreased conscious level (confusion or agitation).
Loss of consciousness.
An Introduction to Assessing Exposure
An Introduction to Assessing Exposure
A severe allergic reaction can cause the skin to become red and itchy, with a rash. It can also cause the eyes, eye lids, mouth or lips to swell.
Look at the person's skin on their face and upper body. Have they got a new, itchy rash? Do they have any swelling to the eyes, eye lids or mouth?
These are often the 1st feature of allergic reactions and are present in over 80% of anaphylaxis.
They can be subtle (for example, patchy erythema) or dramatic (generalised rash).
They may involve the skin, the mucosal membranes (for example, lips), or both.
There may be urticaria (also called hives, nettle rash, weals or welts), which can appear anywhere on the body. Weals may be pale, pink or red, can be different shapes and sizes, and are often surrounded by a red flare. They are usually itchy.
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