ADTMC- Allergic Reactions

Allergic reactions can be complex and range on a scale of severity. The 68W Medic must know how to sort out life threatening emergencies from less severe reactions. The ADTMC protocol can help with this. A screenshot of the ADTMC protocol is at the bottom of the post.

The goals of this post will be to solidify the definition and warning signs of anaphylaxis, to educate some on the physiology behind allergic reactions, and to help the medic have a clearer understanding of how to help a his/her supervising medical provider when treating from a remote location.

Make sure to master the first section: “What is Anaphylaxis?” Then, to become an even better medic, tackle the second section next. Studying “Allergic Reactions Further Explained in Greater Detail” will take some more time and may require additional reading or investigation.

What is Anaphylaxis?

A few different definitions exist. However, I will cite from Uptodate.com the definition proposed by the Second National Institute of Allergy and Infectious Disease /Food Allergy and Anaphylaxis Network symposium from 2006¹. It should be noted that there is no universal agreement on the criteria for diagnosis.

Anaphylaxis is highly likely when any 1 of the following 3 criteria are fulfilled:

1. Acute onset of an illness (minutes to hours) with involvement of the skin, mucosal tissue, or both. Must also include either respiratory compromise (example wheezing, stridor, etc) or reduced blood pressure/syncope or collapse.
2. Two or more of the following that occur minutes to hours after a likely allergen for the specific patient:
   1. Generalized skin involvement or swollen lips/tongue/uvula
   2. Respiratory compromise (example wheezing, stridor, etc)
   3. Reduced BP or associated symptoms such as collapse/syncope
   4. Persistent GI symptoms (abdominal pain, vomiting, cramps, etc)
3. Drop in blood pressure after exposure to a known allergen for that specific patient that occurs in minutes to hours

Anaphylaxis Explained

Allergic Reactions Further Explained in Greater Detail

ADTMC Protocol for Allergic Reactions

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All content is intended to be educational only. Medics should operate under the supervision of a medical provider and abide by all local laws while stateside. Medics should only practice at the level credentialed, and only at the level allowed. This content is not intended to treat or give a substitution for any credentialed provider. Content is intended to aid in a deployed prolonged care setting. Take guidance from your leaders. Utilize these posts as preparation and as a supplement to your provider’s direction and teaching.

This content is the author’s opinion alone and does not necessarily reflect the opinion, official position, or stance of the Department of Defense, or any other branch of the United States Military.

REFERENCES

¹ Sampson HA, Muñoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report–Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006;117(2):391‐397. doi:10.1016/j.jaci.2005.12.1303