Refractory Unforeseen Anaphylaxis Case in a Rural OR Unit. (28th January 2020)

• Record Type: Journal Article
• Authors: Hafizi, Sayed; Nadeau, Christine; Gazarin, Mohamed; Mulligan, Emily
• Other Names: Ganau Mario Academic Editor.
• Is Part Of: Case reports in surgery. Volume 2020(2020)
• Publication Date: 2020-01-28
• Subjects: Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; Surgical Procedures, Operative; General Surgery; Surgery; Electronic journals; Periodicals; Case studies; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 617
• DOI: 10.1155/2020/5283279
• Languages: English
• ISSNs: 2090-6900

Abstract

Abstract : A 35-year-old female patient with no previously documented allergies who was admitted for elective gynaecological surgery, developed rapid onset, severe anaphylaxis, with dyspnea and cardiovascular collapse, in the operating theatre after receiving routine IV cefazolin prior to induction of anesthesia. She failed to improve with two doses of intramuscular epinephrine followed by two boluses of intravenous epinephrine, but responded to an epinephrine infusion. She was assessed by Internal Medicine and discharged home the following day. This event demonstrates the speed, severity, and profound hypotension in an allergic reaction from intravenous medication, challenges in managing anaphylaxis, and importance of prompt administration of epinephrine via IM route, followed by IV if necessary, in the OR. The case highlighted the inability to ascertain the causative agent through typical allergy testing.