BMJ 1995;311:1435 (25 November)

Letters

Treatment takes precedence over monitoring

EDITOR,--We believe that the ability to start immediate and effective treatment for acute anaphylactic shock is an essential skill for any medical practitioner. Unfortunately, Malcolm Fisher may have caused confusion with his recommendations for the use of intravenous adrenaline.1 Fisher contradicts himself by stating that intravenous adrenaline should not be given to an "unmonitored patient" and then subsequently recommends its use in this very situation. We agree that early placement of cardiorespiratory monitoring devices is essential in any severe anaphylactic episode but would strongly urge that the administration of intravenous adrenaline should not be deferred until such equipment is available. In its recommendations for the management of anaphylactoid reactions the Association of Anaesthetists of Great Britain and Ireland emphasises the need for early administration of adrenaline intravenously.2

With regard to the management of bronchospasm, we agree that inhalation of the volatile anaesthetic agent isoflurane may have a role but would . . . [Full text of this article]


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Relevant Article

Fortnightly Review: Treatment of acute anaphylaxis
Malcolm Fisher
BMJ 1995 311: 731-733. [Abstract] [Full Text]

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