ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Anaphylactic shock | Anaphylaxis

Updated on February 28, 2013

What is anaphylactic shock?

Among the most common causes of anaphylactic shock is penicillin (1 response to 5000 exposures), insect venom and application of radiocontrast agents. Anaphylaxis is an acute, life-threatening syndrome with multisystemic manifestations. Anaphylactic shock is the maximum form of early allergic reactions (type I reaction) with acute systemic symptoms and possible lethal (fatal) outcome with the shock. Resulting in a hypersensitive patient (when the patient has already been in touch with the appropriate allergen that lead to hypersensitivity) by entering the antigen (usually parenterally - injection, infusion, insect bite and rarely via oral foodstuffs, drugs).

Possible causes are:

- Drugs (antibiotics, sulfonamides, local anesthetics)

- Serum (gamma globulin)

- Poisons insects (bees, wasps, hornets, ants)

- Hyposensitized solution (eg pollen allergens during immunotherapy)

- Hormones (insulin, estradiol, methylprednisolone)

- Enzymes (streptokinase, trypsin)

- Foods (nuts, flour, milk, fish, shellfish, egg, kiwi)

- Rubber or latex which is located in a surgical glove or gloves in the household.

How to recognize anaphylactic shock?

Commonly occurring are skin lesions: itching, redness, urticaria, angioedema. Swelling of the mucous membranes, itchy eyes, nose and mouth are common symptoms as well as swelling of the lips or tongue which may cause difficulty in breathing and swallowing. Severe signs of anaphylactic reactions are manifested in the form of obstruction of the lower and upper respiratory tract.

Clinical presentation begins immediately after entering the allergen (parenteral intake) or delayed (oral intake). Most reactions occur within one hour of exposure to the antigen. There may occur initial symptoms such as itching skin, numbness of the oral mucosa. Severe signs of anaphylactic reactions are manifested in the form of upper respiratory tract obstruction due to edema of the larynx (throat), epiglottis and surrounding tissues, and bronchoconstriction of the lower respiratory tract with the development of hypoxia. Development of cardiovascular collapse accompanied by hypotension, tachycardia (rapid heartbeat), which can lead to severe arrhythmias.

Because of affecting on gastrointestinal tract it may occur: nausea, vomiting, cramps and diarrhea. Due to reduced blood flow to the brain, and a direct toxic effect of the released mediators there can come to dizziness, restlessness, loss of consciousness.

The main symptoms of anaphylaxis:

- itching, redness, urticaria, angioedema

- dyspnea (difficulty breathing), cough

- rhinorrhea may also occurr (snuffles), "wheezing" (asthmatically breathing)

- difficulty swallowing

- nausea, vomiting, diarrhea, abdominal pain, bloating

- tachycardia (rapid, weak pulse stuffed), hypotension (low blood pressure), arrhythmia (irregular heartbeat), shock

- weakness, chills

- mydriasis (dilated pupils)

- anxiety (feeling of anxiety, fear), tremors (shivering), disturbance of consciousness, syncope (fainting), coma.

Photo credit: tracywoolery / Foter / CC BY-ND

Anaphylactic shock

Have you ever had anaphylactic shock or someone you know? Share your experience.

Have you had anaphylactic shock?

What should be done - urgently seek medical help!

In patients who are at increased risk of anaphylactic reactions (eg people who have had an anaphylactic reaction to an insect bite or food) should always carry a self-help (eg, EPI-PEN, ANA-KIT).

Development of anaphylaxis is extremely rapid and unexpected. In such situations it is necessary to rapidly identify anaphylactic situation, because it might soon turn into anaphylactic shock, which may end fatally. It is necessary to immediately suspend the application of the drug (if that is the cause of anaphylactic reactions), to prevent further absorption of the drug, monitor vital functions (frequency and rhythm of the heart, blood pressure, heart rate, rhythm and depth of breathing), to ensure adequate oxygenation of the patient and to organize the rapid transport of patients the nearest emergency room or hospital. In patients who are at increased risk of anaphylactic reactions (eg patients who have had an anaphylactic reaction to an insect bite or food) should always carry a self-help (eg EPI-PEN, ANA-KIT). EPI-PEN is a system with a syringe needle and adrenaline for single intramuscular administration. ANA-KIT contains two doses of adrenaline pills chlorphenamine (antihistamine) for chewing. In patients with anaphylactic reactions to insect venom should undergo hyposensitization.

Treatment of anaphylactic shock

1.Adrenaline (epinephrine) vials of 1% solution of 1 cc, at a dose of 0.01 mg / kg subcutaneously or intramuscularly. In particularly difficult situations slowly intravenously diluted with saline at a ratio of 1:10. If necessary, repeat the dose every 10 - 20 minutes for up to 1 - 2 times. Immediately after application of adrenaline to find a vein while collapse hasn't yet occurred, and continue to collapse infusion of 0.9% NaCl and 5% Glucosae in the ratio 1:2.

2. Intravenous antihistamines (eg Synopen 0.5 mg / kg slowly over 5-minutes).

3. Aminophylline intravenously 5-7 mg / kg for 10-20 minutes only if it got developed laryngospasm or bronchospasm. Continue infusion mg/kg/24h 15-25. It can be given micronefrin inhalation or some selective beta2 sympathomimetic fast acting (salbutamol or procaterol).

4. Norepinephrine infusion (4-8 mg in l000 ml) with special system for regulating the speed, if the pressure remained low after all the previous interventions. Infusion rate from 0.5 to 3 ml / min. If that's not enough, it can be given dopamine 1-10 mcg / kg / min with pressure control.

5. Corticosteroids are not the treatment of acute anaphylactic shock due to slow action, but are given to prevent further development of allergic reactions.

Along with drug therapy is necessary to:

Lay patient down

Oxygen - through a mask or nasal catheter (5 L / min), as necessary to ensure the airway via oropharyngeal or endotracheal tube. If intubation is not possible due to severe edema required cricoidotomy.

Aspirated secretion from the respiratory tract, occasionally.

Aspirated gastric contents (probe) due to the risk of aspiration with possible vomiting.

Repeated control of blood pressure and pulse.

If cardiac arrest occurs it is required cardiac massage with artificial respiration.

The best prevention of anaphylactic shock is a good anamnesis. Before each injection ask the patient about possible allergic manifestations to him and his family. Nurse, who is first experiencing anaphylaxis, should be trained to have prepared antishock therapy, and to know how to give epinephrine.

Who's got the greatest risk for anaphylaxis?

Everyone who has already survived anaphylactic shock is a potential candidate to have the reaction again. People allergic to food (especially to shellfish, peanuts and nuts) and asthma are at increased risk for the occurrence of life-threatening anaphylaxis. These people are especially vulnerable because it is known that they don’t need to take daily anti-allergic medications and often don’t recognize the early symptoms.

Leave your comments! - Thank you!

    0 of 8192 characters used
    Post Comment

    • TACTCI LM profile image

      TACTCI LM 

      5 years ago

      Super lens and great content about anaphylaxis Lejla1311!

    • pumpum profile imageAUTHOR

      pumpum 

      5 years ago

      @LiliLove: Thank you for visiting.

    • LiliLove profile image

      LiliLove 

      5 years ago

      Very informative and useful lens - thanks for sharing!

    • pumpum profile imageAUTHOR

      pumpum 

      5 years ago

      @tophatpro: You were lucky, definitely. Hopefully it will never happen to you again.

    • tophatpro profile image

      tophatpro 

      5 years ago

      Yeah I have only ever suffered an attack like this once. It's really scary and now I am really careful to make sure I never eat that type of fruit. I was just lucky that I was on uni campus when it happened and the doctor's surgery was next door.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)