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Advanced Allergic Reaction Management: EMS Management of Allergic Reactions and Anaphylaxis

Allergic emergencies are unpredictable. Most respond quickly to intramuscular epinephrine. Some do not. A small but critical percentage of patients progress to refractory anaphylaxis, distributive shock, airway obstruction, and cardiovascular collapse despite appropriate initial treatment. These are the patients who test clinical judgment, airway decision-making, and pharmacologic understanding.

EMS providers must be prepared to:

Recognize early signs of refractory anaphylaxis
Understand the cellular cascade driving persistent shock
Manage advanced airways in edematous anatomy
Escalate pharmacologic therapy beyond initial IM epinephrine
Anticipate complications such as biphasic and protracted reactions
Treat patients with comorbidities that alter response to therapy

This advanced course expands beyond foundational recognition and focuses on high-acuity management, pathophysiology, escalation strategies, and complex case integration.

Designed for Texas EMS providers, this course examines fluid resuscitation strategies, vasopressor considerations, airway failure algorithms, biphasic and protracted anaphylaxis, special populations, and evidence-based updates in EMS management.

Objectives

Upon completion of this course, participants should be able to:

Analyze the advanced immunopathophysiology of severe and refractory anaphylaxis.
Differentiate upper airway edema from lower airway bronchospasm and identify early indicators of airway failure in severe allergic emergencies.
Evaluate clinical findings to identify refractory anaphylaxis and progressive shock.
Recognize indications for pharmacologic escalation beyond intramuscular epinephrine.
Analyze complex presentations of severe anaphylaxis to determine appropriate advanced intervention strategies.

Curriculum

Chapter 1: Advanced Immunopathophysiology

Chapter 2: Advanced Airway Management

Chapter 3: Refractory Anaphylaxis and Shock Management

Chapter 4: Complications, Special Populations, and Evidence Updates

Price: $12.00

Contact Hour: 1

Course Author

Brad Moore

Brad Moore is a dedicated public safety professional with over 18 years of service in emergency response. He has been a firefighter since 2021 and became a licensed paramedic in 2023, providing critical care in high-pressure situations. Before transitioning to Fire and EMS, Brad served for 12 years as a police officer, where he developed strong skills in leadership, crisis management, public safety, and community service. He is also a licensed EMS Instructor through the Texas Department of State Health Services, further extending his expertise in training and education for emergency responders.

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Course Accreditation

Provider approved by the Texas Department of State Health Services, CE Program Approval Number #: 601011. Out of state participants must verify acceptance of this accreditation with their own licensing board.