What’s the difference between anaphylactic and anaphylactoid, and do I need to care? What are the most important ALS medications for anaphylaxis after epinephrine? What the heck is Kounis syndrome? Why didn't they teach me this in class? The past 10 years have seen a dramatic increase in the number of cases of anaphylaxis across the United States. In response, the American College of Emergency Physicians and the World Allergy Organization have issued important updates on initial emergency treatment for patients suffering from anaphylaxis. While epinephrine remains the frontline drug for all levels of care, recent studies show that in-hospital and pre-hospital providers aren’t giving it as often or as early as they should. This interactive case study and pub quiz style presentation answers these questions and many more with a focus on rapid differential of anaphylaxis and effective initial and secondary treatments to manage these immediately life-threatening emergencies.

Regular medical and recreational use of cannabis is on the rise among all age groups. In most cases, this is associated with few side effects, but some regular users experience a wildly paradoxical reaction. While cannabis will normally suppress nausea and pain and stimulate appetite, weekly cannabis use can sometimes produce severe cramping, abdominal pain, vomiting, and nausea known as cannabinoid hyperemesis syndrome (CHS). In this course, we explore the pathophysiology of CHS, discuss presentations that EMS may encounter, and review the current diagnostic and treatment criteria. Current estimates are that cannabinoid hyperemesis syndrome affects potentially 2.7 million people in the United States annually, with significant increases in states with legalization. With complications of CHS including kidney failure, electrolyte imbalance, and skin burns on patients seeking self-treatment, can EMS providers afford to be unprepared?