Anaes SAQs · Critical incidents & patient safety
Collapse after an induction drug — recognition and adrenaline
Final SAQ on perioperative anaphylaxis: the NAP6 culprit ranking with counts, the presenting features, adrenaline by route and dose, the timed tryptase schedule, and mandatory allergy referral with panel testing.
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Prompt
Three minutes after co-amoxiclav and rocuronium at induction, the blood pressure is 55 over 25, the peak airway pressure is 42, the saturation is 91 percent, and no rash is visible under the drapes. Outline your recognition and management of this perioperative collapse.
Question
Three minutes after co-amoxiclav and rocuronium at induction, the blood pressure is 55 over 25, the peak airway pressure is 42, the saturation is 91 percent, and no rash is visible under the drapes. Outline your recognition and management of this perioperative collapse[2][5].
References6ShowHide
- [1]Harper NJN, Cook TM, Garcez T, et al. Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6) Br J Anaesth, 2018.PMID 29935569
- [2]Harper NJN, Cook TM, Garcez T, et al. Anaesthesia, surgery, and life-threatening allergic reactions: epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project (NAP6) Br J Anaesth, 2018.PMID 29935567
- [3]Marinho S, Kemp H, Cook TM, et al. Cross-sectional study of perioperative drug and allergen exposure in UK practice in 2016: the 6th National Audit Project (NAP6) Allergen Survey Br J Anaesth, 2018.PMID 29935566
- [4]Wang J, Lieberman JA, Wallace DV, et al. Anaphylaxis in Practice: A Guide to the 2023 Practice Parameter Update J Allergy Clin Immunol Pract, 2024.PMID 38944199
- [5]Harper NJ, et al. Suspected anaphylactic reactions associated with anaesthesia Anaesthesia, 2009.PMID 19143700
- [6]Dodd A, Hughes A, Sargant N, et al. Evidence update for the treatment of anaphylaxis Resuscitation, 2021.PMID 33895231