Anaphylactic shock - a severe and extremely severe allergic reaction that develops as a result of repeated ingestion of the allergen.
Anaphylactic shock is manifested by a sharp decline in pressure, disturbance of consciousness, local symptoms of allergic phenomena (swelling of the skin, dermatitis, hives, Bronchospasm, etc.) in severe cases coma may develop.
Anaphylaxis usually develops within 1-2 to 15-30 minutes after exposure to allergen and can often result in lethal, with failure to provide quick and correct medical treatment.
Causes
Anaphylaxis is the result of repeated administration of a substance which is a strong allergen for him.
During the initial contact with the substance the body without causing any symptoms it produces enhanced sensitivity and accumulates antibodies to this substance. But repeated contact with the allergen, even in minute quantities, from existing in the body ready-made antibodies enables violent reaction and expressed. Such a reaction of the body most likely to occur on:
- introduction of a foreign protein, sera
- antibiotics
- anesthetics and anesthetic drugs
- other medicines (such as a vein or into the muscle, by mouth)
- Diagnostic preparaov (radiopaque)
- insect bites
- and even when taking certain foods (seafood, citrus, spices)
In anaphylactic shock amount of allergen can be very small, sometimes enough droplets or drug product spoon. But the greater the dose, the stronger and more enduring will be a shock.
The basis of allergic reaction is a massive selection of sensitized cells (hypersensitivity) special substances - histamine serotonin and others who are guilty and in the manifestations of anaphylactic shock.
Kinds
Anaphylaxis can occur in several forms:
- primarily affects the skin and mucous membranes with symptoms of skin itching, severe redness, urticaria or angioedema
- damage to the nervous system with headache, nausea, sensitivity disorders, manifestations of the type of epilepsy and loss of consciousness,
- the defeat of the respiratory system with suffocation and asphyxia, edema of the larynx or bronchial tubes,
- heart failure with signs of cardiogenic shock or acute myocardial infarction
Symptoms of anaphylactic shock
Severity of symptoms, anaphylactic shock can be from mild to extremely severe fatal, it depends on whether the pressure is rapidly reduced, and the work is disturbed brain due to hypoxia (lack oxygen).
In milder forms of anaphylactic shock symptoms can last from a few minutes to two hours and occur
- redness of the skin,
- severe itching and sneezing,
- mucous discharge from the nose,
- sore throat with vertigo,
- headache,
- reduction of pressure and tachycardia.
It may be feeling the heat of the body, discomfort in the abdomen and chest, severe weakness and blurred consciousness.
With an average degree of shock may occur
- blisters on the skin or angioneurotic edema (Quincke)
- phenomena conjunctivitis or stomatitis
- pain in my heart with sharp palpitations, fibrillation and a sharp decrease in pressure.
- patients experience severe weakness and dizziness
- disturbed vision may be agitation or retardation, fear of dying and trembling
- clammy sweat, body cooling, noise in the ears and head, fainting
- bronchospasm may occur with the breathing disorder, bloating or nausea vomiting, severe abdominal pain, disturbance of micturition.
In severe anaphylactic shock almost immediately develops
- vascular collapse with a sharp decrease of pressure, or blueness pallidity, filamentous character pulse, virtually zero pressure
- there is loss of consciousness with dilated pupils, involuntary discharge of urine and feces, the lack of response to external stimuli
- pulse gradually disappears, the pressure ceases to register
- stops breathing and heart activity, clinical death occurs
Diagnostics
Diagnosis is based on data on the drug administration (in contact with the allergen) and the immediate start of the reaction.
State of anaphylactic shock - critical - diagnosis is a doctor or ambulance resuscitation. Anaphylaxis can be similar to other anaphylactic reactions (angioedema or acute urticaria), but the basis of the process is one, as aid.
Treatment of anaphylactic shock
Initiation of treatment is necessary to place any person - whether or not a medical doctor, professional assistance is provided by emergency room doctors and doctors-resuscitators.
First aid for anaphylactic shock
- Emergency call,
- if there is no breathing and heartbeat - indirect heart massage and artificial respiration
- if the person is conscious, it is necessary to lay it on its side, unbuttoned all the buckles and straps clothes, his feet pillow or anything, so that they are raised
- stop delivery of allergen (an insect sting or formulation administered - tourniquet on the limb, removing food from mouth)
Medical assistance - at the point of care delivery to the hospital,
- injection or by the bite must be shot up epinephrine solution subcutaneously or intramuscularly (adults 0.5 ml of 0.1% solution children over 6 years of age - 0.3 ml of a 0.1% solution) and impose ice
- subcutaneously introduce caffeine solutions kordiamina
- also required injection prednisolone or hydrocortisone.
As hospital treatment was repeated injection of adrenaline and hormone antagonists medications administered at dosage allergies, Apply administration of antihistamines, sodium chloride or calcium gluconate. When bronchospasm administered aminophylline, laryngeal edema - shows a tracheotomy or intubation.
Further therapy is based on cardiac disorders, respiratory disorders and metabolic disorders.
Complications and prognosis
The main complication is fatal at the delay in aid. If timely measures possible cure from the shock, but the timing of the removal of shock range from a few hours to several days.
