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When caring for a patient with an anaphylactic reaction, we use the standard ABCDE approach and adjust it to anaphylactic care. The guidelines we are covering in this course are clearly laid down by the UK Resuscitation Council. A link to the full document can be found on the student download area of this course.

With anaphylactic care and the ABCDE approach, it is the same as other critical care for a patient. ABCDE still stands for the same words:
Airway
Breathing
Circulation
Disability
and Exposure to assess and treat the patient.

We will look at the ABCDE breakdown in the next video, but initially complete a full assessment and also re-assess regularly. Then, treat life-threatening problems before moving to the next part of assessment. The entire time, assess the effects of the treatment you are giving. It is very important to call for help early, which can be calling for an ambulance or resuscitation team. When help arrives, communicate effectively and use them effectively to ensure that monitoring and treatment can occur simultaneously.

The aim of the initial treatments is to keep the patient alive and achieve some clinical improvement. This will buy time for further treatment and expert help. It can take a few minutes for treatments to work so keep calm and observant. The ABCDE approach can be used regardless of your training and experience in clinical assessment or treatment. The detail of your assessment and what treatments you give will depend on your clinical knowledge and skills. Whether you recognise a problem or are unsure, call for help.

Finally, let's review the initial stages before we move on to the ABCDE approach. As with all emergency care, ensure personal safety. First, look at the patient in general to see if the patient ‘looks unwell’. If the patient is awake ask, “How are you?” If the patient appears unconscious, shake him gently and ask, “Are you all right?” If he responds normally, has a patent airway, is breathing and has brain perfusion, he is most likely well. If he speaks only in short sentences, he may have breathing problems. Failure of the patient to respond is a mark of critical illness.

Monitor the vital signs early. Attach a pulse oximeter, ECG monitor, and non-invasive blood pressure monitor to all critically ill patients as soon as possible. Only if trained to do so, insert an intravenous cannula as soon as possible.