Glycerin RXN

[DV_EMT]

Ok... Heres one that happened in the hospital. I just want to get opinions based off the given info

A pt was going to have en EEG done, when all of a sudden she starts having a "so called" allergic reaction to the glycerin used to conduct the EEG leads.

RXN was as follows: BP shot up to 216/108. Severe Headache. SOB (R=30ish) but no sign of anaphalaxis/obstructed airway. The patient then proceeded to seize.

Pt is allergic to cortisone(s)


Interventions? further questions?

 

[DV_EMT]

scratch the glycerin... it was actually this stuff

http://www.discountdisposables.com/estore/index.php?act=viewProd&productId=57

 

[Sasha]

That's what RXN meant? Reaction? For some reason I thought it was, RX, prescription with a typo.

 

[MMiz]

Looking at the MSDS shet:

Ten20 Conductive Paste is an off-white, opaque, water-miscible adhesive paste intended for use with non-disposable neuro diagnostic electrodes. Ten20 Conductive Paste is a mixture of the following components: Polyoxyethylene 20 Cetyl Ether, Water,Glycerin, Calcium Carbonate, 1,2 Propanediol, Potassium Chloride, Gel white, Sodium Chloride, Polyoxyethylene 20 Sorbitol, Methylparaben and Propylparaben.

Health Hazards beyond those associated with drying and chapping of skin or minor skin sensitivity have not been demonstrated.

 

[DV_EMT]

But.... a seizure for a rxn>? and what would you do... ativan, benadryl? thats what the nurses did, but any other further interventions?

 

[Ridryder911]

What do you want to me to do? I don't think it was an allergic reaction. She had a seizure..so? She was getting an EEG done... yes; to record seizure activity. As you described no s/s of reactions.

One should not treat an isolated seizure incident. A prolonged or status one; yes.

Nothing more to do except monitor for possibility of another and hopefully you were able to record some of the seizure activity.

I don't think there is any evidence this seizure was induced or there was an allergic reaction. It is not unusual for a patient to become HTN clonic phase.

R/r 911

 

[DV_EMT]

Well...because they thought it was an allergic rxn they disconnected the EEG leads (in case it was the EEG paste), so no record of any of the brain waves.

Epi would be out of the picture cause the BP was too elevated

Benadryl... if it was an actual allergic Rxn?

 

[emtbill]

Epi would be out of the picture cause the BP was too elevated

There are no contraindications to epinephrine in anaphylactic shock. If the patient is having an allergic reaction, and is not in shock, they don't need epinephrine in the first place.

 

[MrBrown]

There are no contraindications to epinephrine in anaphylactic shock. If the patient is having an allergic reaction, and is not in shock, they don't need epinephrine in the first place.

I agree Bill; we had one crew here that transported a genuine anaphylaxis patient and one curious remark they told was of him being in runs of VT. I thought it was really weird so I looked it up and they probably overloaded him on adrenaline!

Any substance to which the body is hypersensitive can cause an allergic reaction so its possible this lady could be allergic to the electrode gel. I am allergic to plastic medical tape; while I don't swell up and die I just get a little anaphylactoid reaction.

For the seizures as R/R said if they are a single seizure I'm not overly concerned about it unless it lasts for > 5 min. We can opt not to transport single, isolated, known seizures.