What problem is a person having with audible wheezes trouble breathing hives and flushed skin with a rapid and weak pulse?

Answer 1

It's difficult to answer these questions without more history -- was the person outside on a sunny, humid day? Insects nearby? Just finished a dinner of shrimp and peanuts? How long have the symptoms existed and are they stable, increasing, or diminishing? That said, I'd first assume this is anaphylactic shock and concern myself with airway issues. The wheezing (bronchospasms resultant from anaphylaxis), hives, and vasodilation are a result of a histamine release into the patient's system. In a first aid context I'd call for emergency evac instantly. If I had meds with me and was licensed and knowledgeable in their use, I'd likely look towards IV or IM diphenhydramine (IV 25-50mg, IM 75mg-100mg), and stand by with the epinephrine. I'd also watch to see if I needed to place an airway before (and if) swelling of the victim's throat made this problematical later, when swelling increased. I'd start O2 mask at 10LPM. If you have a nebulizer available, albuterol can also be used to relieve bronchospasm. IM or subcutaneous Brethine (terbutaline) can be used as well. If the patient is truly shocky (as suggested by rapid and thready pulse), I would place at least one large bore IV and begin fluid resuscitation en route to the hospital, if available. Frequent re-assessment of the airway is a must. If any airway compromise is evident (such as excessive swelling of the mouth or throat, decreased oxygen saturation, or by patient signs of confusion or decreased level of consciousness) I would not hesitate to intubate immediately, before the chance is lost. Repeat doses of epinephrine can be given if needed, either IV or IM. Getting to the hospital as soon as possible is also high priority.