Every year an increasing number of people prone to allergic reactions are increasing. Be sure to know what signs of anaphylactic shock may be, so that you can help a person in time and prevent the death of the victim.
Anaphylactic shock is an acute form of allergy that develops as a result of the secondary exposure of the allergen to the body. It manifests itself in the form of a sharp decrease in pressure, impaired consciousness, local symptoms.
The development of anaphylactic shock mainly occurs within 1-15 minutes from the moment of contact with the allergen and can lead to death of a person if timely assistance is not provided to him.
Pathology Feature
Anaphylactic shock is a serious condition that develops when the body comes in contact with some foreign substances. This condition refers to allergic reactions of an immediate type, in which the combination of antigens with antibodies releases biologically active substances into the blood.
They cause an increase in vascular permeability, impaired blood microcirculation, muscle spasm of the internal organs and a number of other disorders. Blood pressure drops dramatically, while the internal organs and the brain do not receive the required amount of oxygen, which is the main cause of loss of consciousness.
It should be understood that anaphylactic shock is an inadequate reaction of the body to secondary contact with an allergen. That is why it is important to call an ambulance right away, since the consequences can be very serious. It is important to provide emergency care for anaphylactic shock. The algorithm of actions in this case should be clear and coherent, since the life of the victim largely depends on this.
The severity of the patient's condition largely depends on the degree of violation of the immune system. Often anaphylactic shock appears as a complication of a food or drug allergy, but can develop in response to any allergen.
Pathology in children
This type of disease is especially dangerous not only for adults, but also for children. Symptoms develop very quickly, and in case of failure to provide timely help, various complications may arise, in particular, such as:
- cramps
- collapse;
- stroke;
- loss of consciousness.
Similar conditions occur after about 1-2 minutes. With a high degree of damage and a critical condition of the patient, the patient may die. Primary signs include:
- severe weakness;
- nausea;
- headache;
- dizziness;
- increased heart rate.
In some cases, rashes on the skin and mucous membranes are noted. The child may suffocate, and numbness of the limbs is sometimes noted. It is absolutely necessary to carry out complex treatment and prevention of anaphylactic shock in children. It is worth remembering that there is a high probability of a relapse, which is why it is necessary to constantly monitor the child and if abnormalities are found, it is important to immediately carry out the appropriate therapy. Prevention of anaphylactic shock includes the following:
- only medications should be taken;
- monitor nutrition and the situation in the house;
- conduct timely diagnosis and treatment of allergies;
- Avoid contact with the allergen.
With proper and timely treatment and prevention, the prognosis is positive. In the case of a severe stage of anaphylactic shock, the death of a child may occur, especially if assistance is not provided in a timely manner.
Classification
The clinic of anaphylactic shock can be different, and the amount of allergen and its amount usually do not have any effect on the severity of the condition. With the flow, there are such types of pathology as:
- lightning fast;
- slowed down;
- lingering.
The fulminant form occurs literally 10-20 seconds after exposure to an allergen. Among the main manifestations, it is necessary to highlight:
- bronchospasm;
- collapse;
- dilated pupils;
- cramps
- deaf heart sounds;
- fainting;
- involuntary urination and defecation;
- death.
With unskilled or untimely help, death occurs literally in 8-10 minutes. The delayed type reaction occurs after about 3-15 minutes. A protracted form begins to develop in some cases, even 2-3 hours after contact with an allergen.
According to the severity of the course of anaphylaxis, experts divide the pathology into 3 degrees, namely:
A mild degree occurs literally 1-1.5 minutes after contact with the allergen. It manifests itself in the form of itching of the skin, lowering pressure, tachycardia. Locally formed swelling on the skin, reminiscent of a nettle burn.
Moderate anaphylaxis occurs approximately 15-30 minutes after contact with the allergen, but may begin earlier or later. This condition refers to a protracted form of flow. Among the main reactions of anaphylactic shock, bronchospasm, redness and severe itching of the skin should be distinguished.
A severe degree occurs approximately 3-5 minutes after the penetration of the allergen. Among the main signs of this condition, it is necessary to highlight such as:
- severe hypotension;
- labored breathing;
- redness and itching of the skin;
- sharp tachycardia;
- headache;
- cyanosis;
- dilated pupils;
- dizziness;
- fainting;
- cramps.
It is worth noting that the course and outcome of therapy will depend on the speed of care. Anaphylaxis can affect the entire body or only a specific organ. This manifests itself in the form of certain symptoms. The main types of anaphylaxis should include such as:
- typical;
- astmoid
- cardiac;
- abdominal;
- cerebral.
A typical form of the disease is characterized by a decrease in pressure, fainting, shortness of breath, convulsions, as well as skin manifestations. Laryngeal edema is dangerous, since death often occurs in the shortest possible time.
The hemodynamic type of anaphylaxis is characterized by the fact that there are cardiovascular disorders, decreased pressure, pain in the sternum. A comprehensive diagnosis is required, which will distinguish anaphylactic shock from heart disease. Other signs, in particular, such as skin rashes and suffocation, may be absent.
The asphyxical form is characterized by the fact that initially there are problems with breathing due to swelling of the bronchi, larynx, and lungs. All these signs are combined with coughing, a feeling of fever, sneezing, sweating, rashes on the skin. Then there is a decrease in pressure and excessive pallor of the skin. Often a similar manifestation occurs with food allergies.
Cerebral form is rare. It manifests itself in the form of disorders of the nervous system. It is also possible the occurrence of fear, convulsions, headache, respiratory failure. The abdominal form is associated with very severe abdominal pain. They occur about 30 minutes after contact with the allergen. It is characterized by bloating, colic, diarrhea. Be sure to diagnose, as these signs are also characteristic of ulcers and intestinal obstruction.
Who is at risk?
No one is safe from the development of anaphylactic shock. It can begin with absolutely any person, but there is a group of people for whom the risk of a similar problem is much higher than others. These include people who have a history of:
- asthma
- urticaria;
- eczema
- allergic rhinitis;
- dermatitis.
People suffering from mastocytosis are also prone to the appearance of a similar allergic reaction.
It is almost impossible to predict the likelihood of anaphylaxis. She is dangerous for her suddenness. If previously a person had anaphylactic shock, then he needs to have an extract from the hospital with an indication of the clinical picture, as well as allergens that were found after an allergy test.
It is very important to pay attention to well-being when taking previously untried medications, consuming unfamiliar food, visiting botanical gardens with unfamiliar flowering plants. In addition, special care should be taken during walks in nature, to avoid contact with insects and reptiles.
Causes of occurrence
The causes of anaphylactic shock are associated with repeated penetration of allergens into the body. Upon initial contact with this substance, without any manifestations, the body develops sensitivity and accumulates antibodies. And repeated contact with the allergen, even in small quantities, due to the presence of antibodies, gives a very violent reaction. It often arises from:
- the introduction of serum and foreign protein;
- anesthetics and anesthetics;
- antibiotics;
- other medications;
- diagnostic tools;
- consumption of certain foods;
- insect bites.
Depending on the cause of anaphylactic shock, the amount of allergen may be small. Sometimes just one drop of medicine or a small amount of product is enough. However, the higher the dosage, the stronger and longer the shock will be.
The basis of the occurrence of allergies is an increased sensitivity of cells and the release of histamine, serotonin and other substances that are involved in the occurrence of anaphylaxis.
Main symptoms
People who have a non-standard reaction to a certain type of allergen are aware of this and try their best to protect the body from unwanted contact. However, it happens that with the initial penetration of an allergen, it does not cause any reaction at all. With its secondary penetration, a number of signs of anaphylactic shock arise. All these pathological reactions affect:
- skin integument;
- consciousness;
- heart and blood vessels;
- respiratory system.
A violation of consciousness is characterized by the fact that initially a person feels a clouding of consciousness, and also nausea and dizziness can torment him. In addition, such manifestations as:
- a sharp drop in pressure;
- defects of consciousness;
- noise and buzz in the ears.
A little later, a blockage of the centers of the brain is noted, as a result of which the victim turns off consciousness. This manifestation can be short-term or leads to the death of the patient.
At the very beginning of the course of an allergy, skin color changes due to a decrease in vascular tone. Initial hyperemia very quickly gives way to cyanosis, pallor, an unhealthy appearance of the skin. Pathological changes can lead to increased sweating. Large spots may appear on the skin, which, when pressed, turn pale. Then the defects can begin to peel off, and the dead particles are removed from the surface, which is similar to signs of vitamin deficiency or dermatitis.
Among the reactions of anaphylactic shock, a violation in the work of the heart and a decrease in the tone of blood vessels should be noted. As a result of this, the heart rhythm is disturbed and its tones are weakened. The pulse becomes very frequent and may not be heard.
First aid
With anaphylactic shock, the first aid algorithm should be coordinated. At the slightest suspicion of the development of pathology, emergency assistance must be called up. Before the doctor arrives, it is important to stop the flow of the allergen. The emergency action algorithm for anaphylactic shock implies:
- elimination of the action of the allergen;
- neutralization of antigens and antibodies;
- prevention of complications.
It is necessary to begin as quickly as possible the introduction of special anti-shock drugs, which are administered intramuscularly, and in the absence of the desired result, intravenously.
As an adjuvant, you need to take antihistamines. The first aid algorithm for anaphylactic shock implies:
- elimination of signs of asphyxia;
- relief of cardiovascular failure;
- Conducting antispasmodic therapy.
If anaphylactic shock occurred after an insect bite, then a tourniquet should be applied above the bite area. The victim must be given a horizontal position. He should lie on his back with his head slightly tilted to the side. This is to prevent asphyxiation. Then you need to free the neck, chest and stomach to ensure the flow of oxygen.
The first actions of a doctor should be aimed at preventing the subsequent intake of the allergen into the bloodstream. For this, a solution of "Epinephrine" or "Adrenaline" is introduced. It is also allowed to inhale oxygen from an oxygen pillow, and then antihistamines are administered. The victim is hospitalized in a hospital for the treatment and prevention of anaphylactic shock.
Diagnostics
The diagnosis is made on the basis of available information about contact with the allergen and the onset of the reaction. The state of anaphylactic shock is acute and critical, therefore, the diagnosis is made by the resuscitator.
Signs of this condition may be similar to many other anaphylactic reactions, in particular, acute urticaria or Quincke's edema. It is worth noting that relief measures in these conditions are no different.
Treatment
With anaphylactic shock, clinical recommendations include actions such as:
- pressure normalization;
- elimination of bronchospasm;
- other dangerous signs.
When the patient has a feeling of cold, then a heating pad should be applied to the area of passage of the marginal vessels, and then covered with a warm blanket. Be sure to monitor the skin condition during this period.
To save a person’s life, drugs with anaphylactic shock are administered intravenously, as this allows the required therapeutic effect to be achieved much faster. The doctor must strictly control the frequency of administration of the drug, ensuring the vital activity of the body. In particular, such drugs as Atropine, Adrenaline are used.
Solutions need to be injected into a vein and at the same time an indirect cardiac massage should be done. Preference should be given to the veins of the hands, since an injection into the veins of the legs not only slows down the flow of drugs to the heart, but also accelerates the development of thrombophlebitis.
If, for some reason, the intravenous use of the required drugs is difficult, then immediate injection of them directly into the trachea is required. In addition, some resuscitators recommend injecting these funds into the cheek or under the tongue. Due to the anatomical features of these sites, such methods of drug administration make it possible to achieve the fastest therapeutic effect. It is worth remembering that injections should be repeated every 3-5 minutes.
When treating and preventing anaphylactic shock, the clinic is taken into account first of all, since the doctor must correctly assess the patient's condition. Among all the drugs that are used to remove the patient from a dangerous condition, Adrenaline has proven itself very well. The introduction of this medication is carried out with the aim of:
- vasodilation;
- stimulate heart contractions;
- increase the tone of the heart muscle;
- activation of blood circulation;
- increased ventricular contraction;
- increase vascular tone.
In many cases, timely and qualified administration of this drug increases the chances of successfully removing the patient from a dangerous and serious condition of anaphylactic shock. In addition, you need to additionally use "Atropine", which provokes a blockade of cholinergic receptors of the nervous system. As a result of its action, muscle spasm is eliminated, as well as pressure normalizes.
It is worth remembering that too fast the introduction of "Adrenaline" or an overdose of the drug can provoke the occurrence of some violations, in particular, such as:
- very strong increase in pressure;
- angina pectoris;
- stroke;
- myocardial infarction.
To prevent the occurrence of all these complications, especially in older people, the introduction of "Adrenaline" should be slow and at the same time you need to control your heart rate and pressure.
After discharge from the hospital with anaphylactic shock, clinical recommendations must be strictly observed. These include the use of prescribed medications, and subsequent contact with allergens must be excluded.
Possible complications
In the provision of emergency care and the prevention of anaphylactic shock, symptoms must be taken into account, as this will prevent the occurrence of complications and the death of the patient. If you do not provide timely assistance and treatment, then complications may arise, the main of which is death. Death from anaphylaxis can be triggered by reasons such as:
- asphyxia as a result of spasm of the bronchi or lungs;
- respiratory arrest;
- tongue retraction in case of loss of consciousness and convulsions;
- acute respiratory, cardiac, renal failure;
- cerebral edema with irreversible consequences.
A certain percentage of mortality may be due to the fact that the symptoms of anaphylaxis are somewhat similar to signs of a heart attack, an asthmatic attack, and acute poisoning. Help is provided as a patient with these pathologies, and not as a severe course of anaphylaxis.
Forecast and Prevention
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It is advisable to observe a hypoallergenic diet, strengthen the sanitary-hygienic regimen, and not take several medications at the same time, especially antibacterial agents. When using household chemicals, it is recommended to use personal protective equipment. Cosmetic and perfumery products should be used only made on a natural basis. Prevention and treatment of anaphylactic shock includes the additional use of prescribed antihistamines.
During remission, you need to do allergy tests to determine which component the body reacts so violently to. Often the method is often used to prevent anaphylactic shock, which implies the fact that a foreign protein is gradually introduced into the body. First, start with small dosages, which gradually increase.
Those who are predisposed to allergies to insect bites are recommended to use repellents and protective clothing, as well as gloves for gardening, during the warm season. In addition, the required medicines must be in the patient's family.
Knowing what to do and what kind of help you need to provide, you can give a pretty good forecast. Stabilization after treatment should be maintained for a week, and then the outcome can be considered positive. With frequent contact with the allergen, systemic diseases can occur, in particular, such as periarteritis or lupus erythematosus.
Prevention of complications
With anaphylactic shock, prevention also applies to the development of complications. With anaphylaxis, which is accompanied by a sharp and prolonged bronchospasm, emergency care implies an expansion of the lumen of the bronchi. For this, such medications are used as:
- "Ephedrine";
- “Eufillin”;
- Alupent;
- Berotek
- Isadrin.
The drug "Eufillin" helps to weaken the muscles of the respiratory system, intestines and stomach. In the event of prolonged and sustained bronchospasm with hypotension, doctors generally prescribe glucocorticoids, in particular, Hydrocortisone, which is used as an aerosol.
In case of violation of the heart rate, the victim is administered such drugs as:
- "Atropine" with bradycardia;
- "Korglikon" with tachycardia;
- Strofantin.
All of these drugs are administered very slowly intravenously. In anaphylactic shock, the prevention of complications implies the prevention of seizures. In case of overexcitation of the patient and the occurrence of seizures, urgently need to introduce drugs such as Phenobarbital and Diazepam. They are administered very slowly intramuscularly and intravenously at 50-250 mg once.
If there is a suspicion of the presence of cerebral or pulmonary edema, drugs such as ganglion blockers, diuretics should be used. If the doctor notices the patient has bronchospasm, then it is necessary to take appropriate measures to prevent anaphylactic shock and its complications. To do this, you need:
- introduce medications that eliminate bronchospasm;
- take corticosteroids;
- with an increase in asphyxia, an urgent massage of the lungs.
The introduction of drugs is carried out against the background of continuous inhalation using an oxygen pillow. Medications should be administered only intravenously, since intramuscular injections in emergency cases are not effective due to the deterioration of the blood circulation. Stopping breathing, fainting, and lack of pulse are indications for emergency resuscitation.