Prolonged hypotension may be treated several ways.
Plasma or colloids (dextran).
(b) Vasoconstrictors, e.g., metraminol bitarate (Aramine) or
levarterenol bitarate (Levophed).
Isoproterenol or dopamine for reduced cardiac output.
(4) Diphenhydramine chloride helps prevent laryngeal edema. Administer
(5) For convulsions, use intravenous injections of a short-acting barbiturate
or diazepam. Administer over several minutes.
(6) If a patient has prolonged laryngeal edema and hypotension,
corticosteroids are administered. Even if administered intravenously, these will take
one to several hours to act.
c. Following Emergency Treatment. Carefully evaluate the emergency
treatment. It may be necessary to repeat epinephrine or recommend additional
medication. If the reaction is under control, the restrictive band may be removed.
Continue to monitor the patient's vital signs and watch for hypotension and any
Any time you are using a serum with an animal base, extracts which are known
to cause allergic reactions, or contrast media containing iodide, you should have
epinephrine hydrochloride (Adrenalin) available. An antihistamine, aminophylline, and
levarterenol should also be available. The patient should be kept under observation for
at least twenty minutes. If a reaction occurs within the first few minutes, there could be
a medical emergency. Notify the doctor at the first sign of symptoms such as redness
and itching at the injection site, itching eyes, nasal symptoms or a tight feeling in the
chest. If there is a slight reaction, the doctor will order an antihistamine by mouth. In a
more severe case, the antihistamine is given parenterally and a tourniquet should be
applied above the injection site. Adrenalin is frequently injected into the site. Periodic
injections of Adrenalin can be given until the reaction begins to reverse or tachycardia
develops. Aminophylline may be given to relax bronchial spasm and if the blood
pressure is too low, levarterenol can be given. To counteract shock, elevate the
patient's legs, start an intravenous flow and give oxygen by positive pressure mask.
These are some positive steps that you should take.
a. Watch for anaphylactic reactions.