Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Allergies and adverse drug reactionsAllergies and adverse drug reactions[Appraised by Dr Falguni Choksey, January 2010]Give appropriate treatment according to the relevant guidelines of theAssociation of Anaesthetists. Clinical guidelines are available in eachoperating theatre area. After you have resuscitated the patient andsent for senior help, a number of follow-up actions are needed fordiagnosis and further management.Good record-keeping of the chain of events, clinical features andtreatment given in chronological order is essential. The anaphylaxisforms are kept in the guidelines folder on the anaesthesia machine.AnaphylaxisThree blood samples (yellow top or EDTA) are taken in the first 24hours (immediate, one hour and between 6-24 hours). Samples aresent from the UHCW laboratory to the UK national centre at Sheffieldalong with a complete drug history.Malignant hyperpyrexiaThe Malignant Hyperpyrexia Hotline is at 079 4760 9601 foremergencies. Their advice and assistance should be soughtimmediately after contacting the on call consultant.Suxamethonium apnoeaA single blood sample (yellow top) is sent to Leeds forpseudocholinesterase assay. You should expect results in aboutthree weeks and make sure that you follow up the results yourself.Practical actionsCall 26266 (specimen reception) and state the diagnosis and askwhich tests and measurements are currently used (see below).Currently about half of such cases have an inadequate diagnosis,usually due to failure to follow advice on the specimens needed fromthe patient. Follow laboratory instructions as closely as possible.Anaesthetists Handbook January 2010 143