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Paper Chase 3 – Are Steroids Effective in Allergic Reaction

Sanjay Arora, MD and Mike Menchine, MD
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06:12
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Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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01:24

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EM:RAP 2015 August Summary 1 MB - PDF

Do steroids make a difference in acute allergic reaction?

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Sean G., M.D. -

the commentators mentioned essentially benadryl was the mainstay for allergic rxns and epi used much less commonly "only for the severe rxn".... That does not ring true with me. When pts present to the ER for allergic rxns most of the time it is because they are really uncomfortable from hives GI edema, or breathing issues...its rare I see someone with a minor local allergic rxn which is really the only rxn I avoid epi in. H1, H2 blockers and steroids do nothing for the rxns that have already occurred and the only thing that actually reverses the urticaria and edema causing the annoying sx is epi. So I use epi often, for all but the most benign allergic rxns. I use it IM when the rxn is just a bad one system dz, and reserve IV epi for the serious rxns. I think if I gave someone with severe urticaria just benadryl and steroids and sent them home an hour later still covered in hives they would be a bit dissatisfied.

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Quality Review Gets Septic Full episode audio for MD edition 252:40 min - 352 MB - M4AEM:RAP 2015 Août Résumé en Francais Français 62:21 min - 57 MB - MP3EM:RAP 2015 August Canadian Edition Canadian 31:42 min - 29 MB - MP3EM:RAP 2015 August Aussie Edition Australian 58:17 min - 53 MB - MP3EM:RAP 2015 Agosto Resumen Español Español 76:59 min - 71 MB - MP3EM:RAP 2015 August MP3 306 MB - ZIPEM:RAP 2015 August Summary 1 MB - PDFEM:RAP Español Agosto 2015 2 MB - PDFEM:RAP 2015 August Board Review Questions 223 KB - PDFEM:RAP 2015 August Board Review Answers 239 KB - PDF

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