Anaphylactic shock

Anaphylactic shock

(anaphylaxis) is a condition of greatly increased sensitivity of the body. It can occur as a result of repeated introduction into the body of foreign proteins, medicines, with errors in blood transfusion, even with the bite of some insects. Anaphylactic shock is one of the most dangerous complications of drug allergy. Approximately in 10-20% of cases, anaphylactic shock ends lethal.

Anaphylactic shock is accompanied by difficulty breathing, lowering blood pressure, etc. There are several degrees of anaphylactic shock: mild, moderate, severe and extremely severe. Also anaphylactic shock can lead to the predominant defeat of some organs or organ system.

Anaphylactic shock often develops at lightning speed, so it is almost impossible to predict it. However, it is possible to trace allergic reactions to a particular substance and in the future to avoid its entry into the body. Anaphylactic shock is sometimes preceded by some specific symptoms, that is, one can talk about the possible presence of a prodromal period.

Even an insect bite can cause anaphylactic shock.

Of course, not everyone has it. To understand what it is – anaphylactic shock, you can give a simple example. Probably every man at least once in his life was bitten by a bee or wasp – a feeling unpleasant, but not dangerous. Not dangerous for most, but not absolutely for everyone. Some people after a seemingly innocuous bite begin to suffocate and may even lose consciousness. The thing is that this bite is very inadequately reacted by the human body – this is an anaphylactic shock.

One of the most sensitive signs of anaphylaxis is a decrease in blood flow.

The blood flow begins to decrease sharply (therefore anaphylactic shock can develop at lightning speed). First, the peripheral circulation is disturbed, and then the central one. This occurs under the influence of histamine and other mediators, which are produced in large numbers by the cells of the body. In connection with a decrease in blood flow, the skin becomes pale. To the touch, the skin is cold and damp. Also, due to circulatory disturbance, anxiety is observed in the brain and other organs. For this situation, the confusion is characteristic (up to its loss, since the brain and other organs do not receive enough oxygen due to circulatory disorders), breathing problems (shortness of breath). Often disturbed by urination.

A harbinger of anaphylaxis is a local reaction in the place where the allergen hits the human body.

And this is not so much a harbinger of anaphylactic shock as its first symptom. Local reaction is pronounced sharply. It can be very severe pain, swelling in the place that has been bitten by an insect or where the injection of the drug has been made. Often there is severe itching of the skin. If the allergen gets into the body, then anaphylactic shock begins with a sharp pain in the abdomen. In this case, the patient has nausea, vomiting. That is, in this case, you can talk about symptoms of abnormalities of the gastrointestinal tract (gastrointestinal tract). The mouth and larynx are swollen.

Anaphylactic shock is characterized by difficulty in breathing.

Difficulty in breathing is caused by swelling of the larynx, bronchospasm. “Asthmatic” breathing, that is, hoarse, rapid, noisy, always accompanies the development of anaphylactic shock. In addition to difficulty breathing, anaphylaxis is characterized by pale skin and cyanotic lips, fingers, visible mucous membranes, and a drop in blood pressure.

Some patients with anaphylactic shock are convulsed, foam may appear from the mouth, urination and defecation may occur involuntarily, and bloody discharge from the vagina is also possible. All this creates a situation that threatens the life of the patient.

Death can occur within a few minutes or hours after the onset of anaphylactic shock, that is, after the allergen has entered the body. If the patient loses consciousness, then he may die from suffocation in the first 5-30 minutes after getting the allergen into his body. If severe and irreversible changes occur in organs that are vital, death may occur one or two days after the onset of anaphylactic shock.

If, as a result of anaphylaxis, there is a change in the heart, in the brain (for example, brain edema or cerebral hemorrhage), in the digestive tract (for example, intestinal bleeding), in the kidneys, then a person may die after a much longer period of time compared to the cases described above .

In addition, the state of anaphylactic shock is characterized by a situation in which after a while after improving the general condition of the patient, a sharp drop in blood pressure may again occur. Due to all of the above, those persons who have suffered a condition of anaphylaxis should be observed in the hospital for at least two weeks.

There are several degrees of severity of anaphylactic shock.

There are four.

The first degree is easy. Anaphylactic shock lasts from a few minutes to two hours. In this case, it is characterized by the presence of pruritus of the skin, hyperemia of the skin (i.e., increased blood filling of the tissue or organ – in this case tissue). The patient has a headache, dizziness, a feeling of heat, tachycardia, unpleasant sensations in the body, a feeling of tightness in the chest, shortness of breath and more and more increasing weakness.

The second degree is of medium severity. Anaphylactic shock in this case is characterized by a more detailed, compared with mild degree, clinical picture. It is represented by Quincke’s edema (this is an acute allergic reaction, which is associated with rashes of the human body accompanied by edema of the tissues), palpitations, arrhythmias, pains in the heart, lowering of blood pressure. Often the patient has conjunctivitis and stomatitis. The patient may experience feelings of excitement, anxiety and fear. He may have hearing loss and noise in his head. All this is accompanied by strong weakness. Many patients have renal syndrome, such as, for example, frequent urge to urinate, and gastrointestinal syndrome. The latter includes bloating and abdominal pain, nausea and vomiting, etc.

The third degree is severe. Anaphylaxis in this case is associated with the development of acute cardiovascular and respiratory insufficiency. This can be a sharp drop in blood pressure, shortness of breath, and breathless breathing. The latter is a sound of high tonality, which appears due to the exhalation of the air or its inhalation through the narrowed respiratory tube – such constriction may occur as a result of inflammation of the bronchial mucosa. Very often, a severe degree of anaphylactic shock is accompanied by loss of consciousness.

The fourth degree is extremely difficult. Anaphylactic shock leads to the instantaneous development of collapse. Collapse is a condition of the body, which is associated with a sharp decrease in blood pressure, a sharp fall of vascular tone, deterioration of the circulation, resulting in suffering the vital organs (such as heart largely decreases the inflow of venous blood, decreases arterial and venous pressure, may develop hypoxia of the brain). The state of collapse threatens the patient’s life. Also anaphylaxis in this case can lead to the appearance of a coma, which is associated with a rapid loss of consciousness of the patient. Urination and defecation in this case occur involuntarily.

For the fourth degree of anaphylactic shock, the following symptoms are also characteristic: the dilatation of the pupils, the absence of their reaction to light. If the blood pressure continues to fall, then the pulse becomes undetectable. Possible cardiac arrest and cessation of breathing.

Anaphylactic shock can lead to the defeat of individual organs or system.

In this case, the lesion does not extend to the whole organism, but mainly to any part of it. Such variants of anaphylactic shock include the following.

Anaphylactic shock with a predominant lesion of the skin is characterized by the presence of Quincke’s edema, urticaria and severe skin itching, which tends to build up.

Anaphylactic shock with a primary lesion of the nervous system is determined by the presence of a severe headache in the patient. A characteristic feature is also the presence of nausea and the appearance of seizures, accompanied by involuntary defecation and urination. Often the patient loses consciousness.

Anaphylactic shock with primary respiratory damage is associated with the state of suffocation of the patient. In this case, they speak of an asthmatic variant of anaphylaxis. The patient develops asphyxia (that is, a critical condition of the body, which is characterized by the accumulation of carbon dioxide due to lack of oxygen in the body). The reason – the difficulty of patency of the upper respiratory tract. This is due to the laryngeal edema, as well as the violation of normal patency of the middle and small bronchi.

Anaphylactic shock with predominant heart involvement is characterized by the development of myocardial infarction or acute myocarditis. In this case, they speak of cardiogenic anaphylaxis.

An anaphylactic shock is characterized by a period of immunity.

This period lasts for the first two or three weeks after the anaphylaxis is transferred. The period is characterized by the gradual disappearance of allergy manifestations. A patient who has had anaphylactic shock should be extremely cautious. To prevent the re-entry of the allergen into the body, because of which anaphylactic shock developed. The reason for this is that with repeated exposure to an allergen like this, the course of anaphylaxis is more severe. This also applies when after an anaphylactic shock has passed a fairly long period of time (months and years).

Anaphylactic shock can give many complications.

These include myocarditis (ie allergic defeat of the heart muscle), hepatitis (liver disease allergic), glomerulonephritis (allergic kidney damage), as well as a variety of lesions of the nervous system, etc. Possible complications of anaphylactic shock include exacerbations of existing chronic diseases.

Anaphylactic shock should not be confused.

This means that medical care for a patient with anaphylaxis should be given very quickly and clearly. It is necessary to observe the correct sequence of actions. First, immediately it is required to stop the exposure of the allergen to the patient’s body. If the condition of anaphylactic shock has developed as a result of the introduction of a drug into the body, it is necessary to suspend its introduction. If the cause of the anaphylactic shock is an insect bite (for example, a bee), then it is required immediately (but, nevertheless, very carefully) to remove the stinger site with a poisonous pouch.

If there is an objectively conditioned possibility, then it is recommended to apply a tourniquet above that place of bite or drug administration, and then, in order to prevent the spread of the allergen throughout the body, it is necessary to cut off this place with adrenaline solution. This will help create a local spasm of blood vessels.

After the above actions, the patient should be helped to accept a situation in which the probability of tongue twisting will be minimal. In this case, the penetration of vomit into the respiratory tract will also be prevented. Patients with anaphylactic shock should ensure that fresh air enters the body. It is possible to use an oxygen cushion.All this applies to the first measures, which largely depend on the success of further treatment.

Further treatment of anaphylaxis is carried out in order to neutralize biologically active substances, normalize the general condition of the patient. As a result of appropriate treatment, the respiratory and cardiovascular activity of the organism is normalized. It is important to prevent the development of complications after an anaphylactic shock.

Anaphylactic shock is predictable.

In most cases this is far from the case. The state of anaphylaxis can not be predicted. However, it is really each person to pay close attention to how the body reacts to certain foods on a substance, insect bites and so on. D. If there is an allergic reaction, it is necessary to strictly guard against their re-enters the body. After all, repeated exposure can lead to a state of anaphylactic shock. Thus, it can be concluded that the prevention of anaphylactic shock largely depends on a carefully collected allergic anamnesis.

Observations and studies show that anaphylactic shock develops only (!) As a result of repeated exposure of the allergen to the body. If the patient has not previously been exposed to an allergen, then he is beyond the danger of developing an anaphylactic shock.

It is also known in science that the state of anaphylaxis is usually preceded by allergic reactions that do not lead to it. Those persons who have suffered the condition of anaphylactic shock should always have a card on which the allergen leading to anaphylaxis is indicated. It is necessary to have a special anaphylactic kit, which, if necessary, will be used. All this, of course, you should always have with you (and not just at home in a secluded place).

The type of allergen does not affect the overall clinical picture of the patient’s condition.

Allergen does not affect the severity of anaphylaxis. Due to the above it can be concluded that the clinical picture of anaphylaxis is varied, as can be judged on the basis and in the following data: when comparing the five hundred cases of anaphylactic shock, all of which are caused by different allergens, it was not recorded even two cases, such to match the clinical picture. Each case of development of anaphylaxis had its own set of symptoms, differed from others in the severity of the flow, could have prodromic (i.e., preceding) phenomena, and might not have.

An anaphylactic shock is characterized by the presence of a prodromal period.

To be more precise, it should be said that the state of anaphylaxis can be preceded by a prodromal period, but it may not be. In the latter case, anaphylactic shock develops instantaneously and leads to collapse – the patient loses consciousness. This condition is characterized by the presence of convulsions. Often a person dies.

opinions of the authors, exploring the problem of anaphylactic shock, is that some of the elderly, the dying, seemingly from cardiovascular disease, in fact, die from anaphylactic shock as a result of, for example, an insect bite. In this case, often timely medical assistance can not be provided.

If the prodromal period does take place, then its duration varies from a few seconds to an hour. The prodromal period is usually associated with the appearance of a feeling of fever, excitement, or weakness and depression in the patient, chest pain that can be described as constrictive, a headache and some other phenomena. Quite often (but still not always) in the prodromal period, the following phenomena occur: itching of the skin, lacrimation, perspiration and coughing (dry). The skin may develop a rash, and swelling may occur. The prodromal period ends with the appearance of symptoms that describe the actual picture of anaphylactic shock.

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