一連兩日,星期六同日都去左PMH上堂,好明顯又係唔使錢,如果唔係你真係好難搵到一個男護士上兒科既堂GA........整體黎講,雖然兩日都係英文教學,但都唔係完全唔明人地講咩,今日寫BLOG有好多TOPIC都想分享,但首推既一定係Management of Anaphylaxis and Severe Allergic Reactions。首先講講處理 Anaphylaxis既原則先:
C Clinical features
A Avoidance of allergens
R Review and Reassessment
E Emergency plan and Epinephrine autoinjector
Clinical features
Anaphylaxis(過敏性反應),可分為兩大類:
1. Allergic anaphylaxis
2. Non-allergic anaphylaxis
而Allergic anaphylaxis又可再分為:
1.1 IgE-mediated anaphylaxis
1.2 Immunologic, non-IgE-mediated anaphylaxis
Avoidance of allergens
allergen(過敏原),即係一D物質當一個人接觸到之後會引起過敏反應(人人唔同),e.g. 有D人會對花粉起過敏反應,有D人唔會。而響小朋友當中,食物係最常引起過敏反應既過敏原。food is the number 1 trigger,而當中最常引起過敏反應既食物排名如下:
第一位 shellfish, fish and seafood not specified
第二位 cow milk and dairy
第三位 egg
第四位 penunt and tree nut
Angioedema <18歲 = 5 / 100 000
Anaphylaxis <18歲 = 1 / 100 000
Anaphylaxis Shock(過敏性休克) due to food <18歲 = 0.5 / 100 000
Review and Reassessment
1. 詳細既家族史評估(family allergic history)
2. 過敏原皮膚測試(allergy skin test)
3. 放射性過敏原吸收試驗(radioallergosorbent test; RAST)
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