The summary and a few nitbits:
Anaphylaxis is a medical EMERGENCY.
In anaphylaxis, death occurs through respiratory arrest. Forget intubation or tracheostomy*. The airway blockage is at the level of the bronchi below the larynx.
The first thing to do is yell for the ADRENALINE (epinephrine).
Then, in order:
- lay the patient down and raise the feet
- ensure the airway is free
- monitor blood pressure
- give adrenaline 1ml of 1 in 1000 intramuscularly or intravenously
- give antihistamines and/or hydrocortisone
- if hypotensive, give intravenous infusion of fluid (colloid better than crystalloid)
- if still hypoxic, oxygen and/or assisted ventilation may be necessary (this is when you can consider the intubation or trachy)
*There might be a place for intubation/tracheostomy if CPAP (continuous positive airway pressure) is available.