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Airway Management in Anaphylaxis

airway management anaphylaxis anaphylaxis management patient safety May 13, 2024
The priority with anaphylaxis management is adrenaline and intravenous fluids. Thankfully, with intraoperative anaphylaxis, there is often a secure airway in place already. If the patient has no airway, then be prepared to intubate based on the severity of the anaphylaxis. Although most cases will need intubation, some mild cases may not. 🙏✅
 
If there is a well-fitting LMA in situ, your team does not need to convert to an endotracheal tube unless adequate ventilation cannot be achieved using an LMA. Once the patient has been stabilised with adrenaline and fluid therapy, elective intubation can occur in preparation for transfer to the intensive care unit.
 
Here are the key points about airway management in anaphylaxis:
 
👉 Use 100% O2
👉 Always confirm airway position with waveform end-tidal CO2
👉 Intubation is indicated in severe bronchospasm, pulmonary oedema, or prior to ICU/interhospital transfer.
 
Concerns about upper airway oedema are not reflected by the literature. According to the 6th National Audit Project on Anaphylaxis, less than 1% of cases involved upper airway swelling.
 
As we always say, oxygenation is more important than the choice of device. Remember the Vortex Approach if you end up in an airway rescue scenario!
 
Build knowledge ✅
Improve safety ✅
 
Ref: https://www.rcoa.ac.uk/nap6-perioperative-anaphylaxis
 

 

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