Flaming Hot Lips

Author: Priyanka Neelima Pillai / Editor: Nick Tilbury / Codes: AP3, SLO3 / Published: 24/06/2022

A 50-year-old female is alerted in as anaphylaxis after developing swollen lips and tongue whilst eating out at an Indian restaurant with friends. She has been given 9 doses of intramuscular adrenaline by the paramedics prior to arrival.

On arrival her observations are:

• BP – 170/90,
• HR – 140 (sinus tachycardia)
• RR – 24
• SpO2 – 98% on 15l/min O2 via NRB

The patient is sitting up and alert but is unable to speak due to extensive tongue and lip swelling. There is mildly laboured breathing but no other sign of respiratory distress or stridor. She has had an uneventful transfer to the hospital. Her past medical history includes hypertension and she is a smoker. She is not known to have any allergies and is on Lisinopril and Simvastatin. She is otherwise fit and well. This is this first time this has happened.