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Urticaria or Angioedema Clinical Pathway, Emergency Department and Primary Care – History and Physical

Urticaria or Angioedema Clinical Pathway — Emergency Department and Primary Care

History

Past Medical History
  • Allergy to food, drugs, insects
  • Chronic urticaria
  • Hereditary angioedema
  • Family hx of HAE
Onset/Progression
of Symptoms
  • Trigger with rapid onset of symptoms
    • Progression mins to hrs vs. over 24 hrs
  • Treatment administered and response
Rash
  • Are individual lesions fixed (> 24 hrs) or transient (< 24 hrs)
  • Location, localized or generalized
  • Duration < or ≥ 6 wks
  • Itchy
  • Painful
  • Associated edema, localized or generalized
Evaluate for
Possible Triggers
  • Viral symptoms
  • Food
  • Medication
    • Antibiotics
  • Contact, insect
  • Temperature
Systemic Symptoms
  • Weight loss
  • Fever
  • Joint pain
  • Malaise

Physical Exam

General Appearance Ill-appearing or toxic
Eye
  • Periorbital edema
  • Conjunctival injection
Mouth Mucositis
Lymphatics Lymphadenopathy
Skin
  • Blanching, non-blanching
  • Dermatographism
Musculoskeletal Swollen joints
GU
  • Perineal edema
  • Scrotal edema

 

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