Allergic emergencies seen in surgical suites

Desensitisation to subcutaneous insulin using CSII followed by i-Port Advance™

“…This is not the first description of the use of CSII to treat localised insulin allergy in patients with either type 1 or type 2 diabetes, [2][3][4][5][6] and our patient's symptoms were significantly and sufficiently improved rather than cured. However, we are not aware of other examples where i-Port Advance™, a device that has been developed to make it possible for people with needle phobia to be able to inject insulin themselves, has been used for this indication.…”

The awareness of anaphylaxis reaction to local anesthesia in Dentistry

“…The incidence of anaphylaxis is, however, very rare and the incidence of anaphylaxis and anaphylactoid reactions during anesthesia is very difficult to estimate but has been calculated to range from 1 in 3,500 to 1 in 13,000 cases [7,8]. Another report from Australia estimated the incidence to be between 1 in 10,000 and 1 in 20,000, whereas the most recent report, from Norway, estimated the incidence to be 1 in 6,000 [9][10][11].…”

Anesthetic Management of a Patient with an Allergy to Propylene Glycol and Parabens

“…The incidence of adverse reactions, including allergic reactions, to anesthetic drugs has been estimated between 1 in 3500 and 1 in 20,000 patients. [12][13][14] Immune and nonimmune-mediated allergic reactions traditionally occur upon reexposure to specific antigens, although first exposure may precipitate a reaction because of cross-reactivity among many commercial products and drugs. 3 The reaction reported by our patient was not consistent with a typical type I hypersensitivity reaction, which includes a pruritic rash within 1 hour of exposure, respiratory difficulty, gastrointestinal manifestations, or angioedema.…”

“…Propylene glycol toxicity must be differentiated from allergic sensitization; toxicity reactions generally manifest as serum hyperosmolality, respiratory depression, central nervous system depression and seizures, and an anion gap metabolic acidosis after topical, oral, or parenteral exposure. [7][8][9][10][11][12][13][14] The management of suspected propylene glycol toxicity should involve the discontinuation of any potential source, the administration of IV fluids to dilute the suspected agent and modulate vasomotor instability, and the institution of appropriate supportive measures. Hemodialysis or continuous venovenous hemofiltration can be helpful.…”