Ovarian torsion identified on point-of-care ultrasound in the paediatric emergency department

Abstract

inform the treating clinician to make the most appropriate decision for each individual situation. Nitrates may not be appropriate in the setting of anaphylaxis as they may worsen hypotension. Additionally, opioids such as morphine may induce mast cell degeneration, aggravating the anaphylaxis. Beta-blockers counteract the actions of adrenaline in anaphylaxis and some literature suggests not using them at all when acute coronary syndrome is suspected in the setting of anaphylaxis. Even aspirin is potentially detrimental, producing more anaphylaxis mediators through cyclo-oxygenase inhibition. These medicines are commonly used in the early hospital management of acute coronary syndrome, and it is unclear what the optimum management for patients with concurrent anaphylaxis and MI is. This case highlights the need to outweigh the relative urgency and risk of anaphylaxis and its treatment against the risks of acute coronary syndrome and its treatment.