Anaphylaxis - an allergic reaction of immediate type, the development of which is associated with the re-ingestion of the allergen.
Anaphylaxis is the most severe manifestation of allergic reaction that develops in response to the introduction of foreign proteins, organic chemicals.Very often lately registered anaphylactic shock after the administration of certain drugs.The severity of the patient's condition is directly dependent on the type of material, the introduction of which resulted in the development of allergic reactions, dosage and route of administration, since according to the data of the static state, life threatening, most often occur after administration of substances by the parenteral route than enteral.
To distinguish several variants of anaphylactic shock, depending on the particular symptoms, comes to the fore: the typical, cardiac, abdominal, cerebral, osmotic.
Depending on the duration of the light period preceding the occurrence of anaphylactic shock, usually distinguished:
• lightning shape (develops within 1 to 2 minutes after ingestion of the allergen);
• severe (5-7 minutes);
• anaphylactic shock moderate (an allergic reaction develops within half an hour from the time of exposure of the allergen);
• mild anaphylactic shock.
characteristic symptoms of anaphylactic shock are:
• preservation of consciousness (cerebral form of possible loss of consciousness);
• anxiety, agitation;
• 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, marked anxiety, paroxysmal cough, abnormal respiratory rate, possible vomiting, drop in blood pressure, increased heart rate - 90 beats per minute, arrhythmia.The most often seen combination of disordered breathing and cardiovascular functions.The main cause of death from anaphylaxis in children is a swelling of the larynx.As for adults, they have, along with swelling of the upper respiratory tract are observed cardiac arrhythmia.The duration of the symptoms of anaphylactic shock varies and can range from a few seconds up to 30-40 minutes, and the faster the shock develops, the prognosis is more serious.This is due to the fact that the development of shock in this case there is a massive release of kinins and histamines blood that disrupt vascular permeability and causing bronchospasm lead to tissue edema.
• cessation of administration of the drug, which caused the development of allergic reaction;
• moving the patient in a horizontal position;
• administering subcutaneously around the injection site of the drug substance of 0.1% epinephrine solution in saline.Introduction of adrenaline saline solution in different areas of the body to normalize vascular tone;
• glucocorticoid drugs: prednisolone 90-120 mg hydrocortisone 600-800 mg intravenously or under the tongue;
• rare breath;
• abdominal pain;
• nausea, vomiting;
• involuntary acts of urination and defecation;
• antihistamines after restoration of blood pressure: 4.3 ml of 1% diphenhydramine solution or 2 ml of 2% solution suprastina intravenously or intramuscularly;
• for removing toxins from the body sodium thiosulfate 30% 10 ml intravenously;
• on the testimony of 1 ml of 0.06% strength Korglikon solution for the normalization of cardiac activity;
• the development of anaphylactic shock in response to the introduction of penicillin must enter penicillinase 1 million units in saline.
mandatory in anaphylactic shock is the call "ambulance" and hospitalization of the patient in the hospital.
If anaphylactic shock in the prehospital emergency care is provided in the following order:
• to block venous outflow above the injection site or bite on a limb tourniquet is applied;
• 0,5 ml of epinephrine 1: 1000 dilution is administered subcutaneously, the same amount injected into the injection site or a bite.If the victim systolic blood pressure below 100 mm Hg.Art., Epinephrine dose of 0.5 ml is slowly injected intravenously in 20 ml of isotonic sodium chloride solution;
• in order to avoid occurrence of ventricular fibrillation in response to the lack of oxygen due to laryngeal edema and blood pressure decrease in the patient should be given oxygen, as in most cases, heart disorder is the cause of death in anaphylactic shock;
• in the case of pronounced edema of the larynx and airway obstruction must perform konikotomiyu via Dufour needle on which then enter the catheter through which will be breathing.
After performing the above activities the patient can be transported to the hospital, otherwise:
• as in anaphylactic shock and a decrease in circulating blood volume, we recommend the introduction of adrenaline or polyglucin;
• 2,4% solution of aminophylline solution in a volume of 5-10 ml is administered intravenously to relieve bronchospasm;
• antihistamines administered to treat skin rashes;
• intravenous corticosteroids.