Sandbox vidit5: Difference between revisions
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==Management== | |||
Shown below is an algorithm summarizing the approach to <nowiki>[[disease name]]</nowiki>. | |||
{{familytree | | {{familytree/start |summary=PE diagnosis Algorithm.}} | ||
{{familytree | | | | | | | | A01 |A01=<div style="float: left; text-align: left; height: 45 em; width: 45em ">'''Characterize the symptoms & signs:''' <br> Skin, subcutaneous tissue and mucosa: <br> ❑ Flushing, itching, urticaria, angioedema, rash, piloerection <br> ❑ Periorbital itching, erythema and edema; conjunctival erythema, tearing <br> | |||
{{familytree | | | | | | | | | | ---- | ||
Respiratory: <br> ❑ Nasal itching, congestion, rhinorrhea, sneezing <br> ❑ Throat itching and tightness, dysphonia, hoarseness, stridor, dry staccato cough <br> ❑ Tachypnea, dyspnea,chest tightness, wheezing/bronchospasm <br> ❑ Cyanosis <br> ❑ Respiratory arrest <br> | |||
{{familytree | ---- | ||
{{familytree | | | | | | | | | | | | | | | | | Gastrointenstinal: <br> ❑ Pain, nausea, vomiting, diarrhea <br> | ||
---- | |||
{{familytree | Cardiovascular: <br> ❑ Chest pain, tachycardia, palpitations <br> ❑ Hypotension, feeling faint <br> ❑ shock <br> ❑ Cardiac arrest <br> | ||
{{familytree | ---- | ||
{{familytree | Central nervous system: <br> ❑ Anxiety, irritability <br> ❑ Throbbing headache <br> ❑ Altered vision and mental status </div>}} | ||
{{familytree | | | | | | | | | {{familytree | | | | | | | | |!| | | | | | | | }} | ||
{{familytree | {{familytree | | | | | | | | B01 | | | | | | | |B01=<div style="float: left; text-align: left ">'''Consider alternative diagnosis:''' <br> ❑ Acute asthma <br> ❑ Anxiety/Panic attack <br> ❑ Syncope </div>}} | ||
{{familytree | | | | | {{familytree | | | | | | | | |!| | | | | | }} | ||
{{familytree | | | | | | | {{familytree | | | | | | | | C01 | | | | | |C01=Remove patient from exposure/trigger }} | ||
{{familytree | | | | | | | | | | | | | | | {{familytree | | | | | | | | |!| | | | | | }} | ||
{{familytree | | | | | | {{familytree | | | | | | | | D01 | | | | | |D01=<div style="float: left; text-align: left">Do all 3 simultaneously <br> ❑ Call for help <br> ❑'''Inject aqueous epinephrine (adrenaline) IM in the mid-anterolateral aspect of the thigh, 0.01 mg/kg of a 1:1,000 (1 mg/mL) solution''' <br>Maximum dose 0.5 mg (adult) or 0.3 mg (child) <br> Record the time of the dose and repeat it in 5-10 minutes, if needed or <br> ❑ In patients with hypotension/cardiorespiratory arrest and those not responding: Intravenous epinephrine <br> 1:100,000 solution of epinephrine (0.1 mg [1 ml of 1:1000] in 100 ml saline) intravenously by infusion pump at an initial rate of 30-100 ml/hr (5-15 mg/min) <br> Titrate based on clinical response or epinephrine side effects <br> ❑ Place patient on back/comfortable position; elevate legs</div> }} | ||
{{familytree | | | | | | | | | | | | | | | | | {{familytree | | | | | | | | |!| | | | | | | }} | ||
{{familytree | | | | E02 |-| E01 | | | | | | | |E01= Patient has one of the following? <br> ❑ Respiratory distress <br> ❑ Recieved repeated doses of epinephrine <br> ❑ Asthma/other respiratory disease <br> ❑ Co-existing cardiovascular disease |E02=Yes}} | |||
{{familytree | | | | |!| | | | | | | | | | | | }} | |||
{{familytree | | | | F01 | | F02 | | | | | | |F01=Give high flow supplemental oxygen (6-8 L/min) |F02=No }} | |||
{{familytree | | | | |!| | | | | | | | | | | | }} | |||
{{familytree | | | | |`|-|-| G01 | | | | | | | |G01= Establish IV access <br> 1-2 litres of 0.9% saline rapidly}} | |||
{{familytree/end}} | {{familytree/end}} |
Revision as of 21:26, 15 January 2014
Management
Shown below is an algorithm summarizing the approach to [[disease name]].
Characterize the symptoms & signs: Skin, subcutaneous tissue and mucosa: ❑ Flushing, itching, urticaria, angioedema, rash, piloerection ❑ Periorbital itching, erythema and edema; conjunctival erythema, tearing Respiratory: Gastrointenstinal: Cardiovascular: Central nervous system: ❑ Anxiety, irritability ❑ Throbbing headache ❑ Altered vision and mental status | |||||||||||||||||||||||||||||||||
Consider alternative diagnosis: ❑ Acute asthma ❑ Anxiety/Panic attack ❑ Syncope | |||||||||||||||||||||||||||||||||
Remove patient from exposure/trigger | |||||||||||||||||||||||||||||||||
Do all 3 simultaneously ❑ Call for help ❑Inject aqueous epinephrine (adrenaline) IM in the mid-anterolateral aspect of the thigh, 0.01 mg/kg of a 1:1,000 (1 mg/mL) solution Maximum dose 0.5 mg (adult) or 0.3 mg (child) Record the time of the dose and repeat it in 5-10 minutes, if needed or ❑ In patients with hypotension/cardiorespiratory arrest and those not responding: Intravenous epinephrine 1:100,000 solution of epinephrine (0.1 mg [1 ml of 1:1000] in 100 ml saline) intravenously by infusion pump at an initial rate of 30-100 ml/hr (5-15 mg/min) Titrate based on clinical response or epinephrine side effects ❑ Place patient on back/comfortable position; elevate legs | |||||||||||||||||||||||||||||||||
Yes | Patient has one of the following? ❑ Respiratory distress ❑ Recieved repeated doses of epinephrine ❑ Asthma/other respiratory disease ❑ Co-existing cardiovascular disease | ||||||||||||||||||||||||||||||||
Give high flow supplemental oxygen (6-8 L/min) | No | ||||||||||||||||||||||||||||||||
Establish IV access 1-2 litres of 0.9% saline rapidly | |||||||||||||||||||||||||||||||||