Anaphylactic shock symptoms
Apr 21, 2018
Anaphylactic shock is an allergic reaction of an immediate type, the development of which is associated with the repeated ingestion of an allergen.
Anaphylactic shock is the most severe manifestation of an allergic reaction that develops in response to the introduction of foreign proteins, organic chemicals. Especially often anaphylactic shock is registered recently after the administration of certain medications. The severity of the patient's condition is directly dependent on the type of substance, the introduction of which led to the development of an allergic reaction, dose and route of administration, since according to static data, life-threatening conditions are more often observed after the administration of substances parenterally than enteral.
It is common to distinguish several variants of anaphylactic shock, depending on the characteristics of the symptoms that come to the fore: typical, cardiac, abdominal, cerebral, osmotic.
Depending on the duration of the light interval preceding the onset of anaphylactic shock, it is customary to isolate:
• fulminant form( develops within 1-2 minutes after ingestion of the allergen);
• heavy form( after 5-7 minutes);
• anaphylactic shock of moderate severity( allergic reaction develops within half an hour from the moment the allergen enters the body);
• an easy form of anaphylactic shock.
Characteristic symptoms of anaphylactic shock are:
• Preservation of consciousness( in the cerebral form, loss of consciousness is possible);
• anxiety, excitement;
• redness of the skin;
• pain in the heart;
• expiratory dyspnea;
Clinical manifestations of anaphylactic shock are various combinations of such signs and symptoms as generalized redness, rash, severe anxiety, paroxysmal cough, impaired breathing rhythm, possible vomiting, falling blood pressure, heart rate increase - more than 90 beats per minute, arrhythmia. Most often one can observe a combination of breathing disorders and cardiovascular system functions. The main cause of death in anaphylaxis among children is laryngeal edema. As for adults, they have cardiac rhythm disturbances along with edema of the upper respiratory tract. The duration of the development of symptoms of anaphylactic shock is different and can range from a few seconds to 30-40 minutes, and the faster the shock develops, the more serious the prognosis. This is due to the fact that with the development of the shock state in this case, a massive release of histamines and kinins into the blood that break the permeability of the vascular wall and, causing bronchospasm, lead to swelling of the tissues.
• discontinuation of the administration of the drug that caused the allergic reaction;
• moving the patient to a horizontal position;
• Subcutaneous injection of 0.1% solution of epinephrine in saline around the injection site. The introduction of a solution of epinephrine with physiological solution in different parts of the body to normalize the vascular tone;
• glucocorticoid drugs: prednisolone 90-120 mg, hydrocortisone 600-800 mg intravenously or under the root of the tongue;
• rare breathing;
• abdominal pain;
• nausea, vomiting;
• involuntary acts of urination and defecation;
• antihistamines after restoration of blood pressure: 3-4 ml of 1% solution of diphenhydramine, or 2 ml of 2% solution of suprastin intravenously or intramuscularly;
• To remove toxins from the body, sodium thiosulfate 30% 10 ml intravenously;
• according to the indications of 1 ml of a 0.06% solution of Korglikona for normalization of cardiac activity;
• With the development of anaphylactic shock in response to the introduction of penicillin, penicillinase 1 million units should be administered in physiological saline.
Obligatory for anaphylactic shock is the call of "Emergency Medical Care" and hospitalization of the patient in a hospital.
In case of anaphylactic shock in the prehospital stage, emergency care is rendered in the following order:
• in order to block the venous outflow above the injection site or bite the limb;
• 0.5 ml of adrenaline diluted 1: 1000 is administered subcutaneously, the same amount is injected into the injection or bite site. If the affected systolic blood pressure is less than 100 mm Hg.st, adrenaline in a dose of 0.5 ml is injected slowly intravenously into 20 ml of isotonic sodium chloride solution;
• In order to avoid the occurrence of ventricular fibrillation in response to a lack of oxygen due to edema of the larynx and reduce blood pressure, the patient should be given oxygen, as in most cases, cardiac dysfunction is the cause of death in anaphylactic shock;
• in case of marked laryngeal edema and obstruction of the airways, it is necessary to perform a conicotomy with DuPhu's needle, after which you can then insert a catheter through which breathing will be carried out.
Already after the above measures, the patient can be transported to a medical institution, otherwise:
• Since anaphylactic shock also decreases the volume of circulating blood, it is recommended that adrenaline or polyglucin be administered;
• A 2.4% solution of euphyllin in a volume of 5-10 ml is administered intravenously to relieve bronchospasm;
• antihistamines are administered to treat skin rashes;
• intravenously injected corticosteroids.