Fentanyl and Anaphylaxis

[akflightmedic]

So the below paste is from an ER RN FB thread. A lot of discussion but no answers…

1. Why fentanyl?
2. What is indication for narcs?
3. Any studies out there or any of y’all heard of this?

And yes I asked her why she allowed it to be given especially when the treating RN had no explanation and the treating provider refused to speak to her and explain.

“Question - Very seasoned ER nurse here- I have a family member to has idiopathic anaphylaxis- when she has a reaction develops hives, welts, airway constriction and stridor- has been intubated 3x for same. The last event when she presented to the ER I expected racemic epi, Benadryl, Pepcid , solu medrol and perhaps more Epi- however the doctor did not provide steroids, but gave Fentanyl- and did not provide a good reason why- Any one else here seen Fentanyl given in anaphylaxis?”

 

[Carlos Danger]

What was given in addition to the fentanyl? What was the outcome?

Never heard of fentanyl as a therapy for anaphylaxis, but can think of a few potential reasons why it might possibly be given in such a scenario. Not nearly enough info to really have much else to say on it.

 

[mgr22]

While I've never heard of Fentanyl administered for anaphylaxis, I believe opiates have immunosuppressant properties. Fentanyl is also less likely to provoke histamine release than, say, morphine. Perhaps those two points have something to do with the doctor's decision in the above case.

 

[E tank]

He could have just been wanting to provide some anxiolysis. And there's always the possibility he wasn't making a completely sensible decision, even thought it was a benign one.

 

[PotatoMedic]

I've given fentanyl and caused anaphylaxis. Though it could have also been the zofran...

But never heard of fentanyl to treat anaphylaxis.

 

[DrParasite]

To... stop the pain from the reaction?

that's a new one for me...

 

[akflightmedic]

I have no further updates from that post. Sorry we all will be left hanging. LOL. I truly was just checking here to see if anyone else have heard such. I did question the poster as best as I could without risk of being banned from that group, LOL...cause I was truly dumbfounded how a "well seasoned ER nurse" who is present in the room would allow any medication to remain unexplained or tolerate a treating RN just shrugging their shoulders and pushing the med, or allowing the provider to not even engage in discussion when requested. I do think there is far more to the story, however I could not push as much. RNs in general are a very clique-esque group, heavy complainers, and drama creators. They are often their own worst problem. LOL

But I cannot say that in a FB group comprised of RNs, otherwise I get the boot! Ha Ha Ha.

 

[CCCSD]

Probably a 30 year Con Home “RN” who didn’t have her hearing aids turned up and misheard…

 

[MackTheKnife]

Probably a 30 year Con Home “RN” who didn’t have her hearing aids turned up and misheard…

Nope, the batteries were dead and the tubes clogged with cerumen.