Emergency care for anaphylactic shock: delivery algorithm, necessary actions and basic rules

With allergies, anaphylactic shock is dangerous. When this condition occurs, you need quick help. You need to know how to act in this situation before the arrival of doctors. With anaphylactic shock, the emergency care algorithm will help save a person’s life.

This condition in medicine is considered instantaneous. Shock occurs in individuals who are prone to allergies. Usually observed with primary or secondary exposure to a provoking factor. The emergency algorithm is simple. About him and will be described in the article.

Signs

There are several stages of the course of this condition:

1. Lightning fast. Signs include the development of vascular, respiratory, heart failure. In most cases, it is not possible to save a life.
2. Lingering. Shock occurs with the introduction of drugs prohibited for allergy sufferers. In this case, intensive care is carried out, the duration of which is several days.
3. Abortive. In this case, there is no threat to the life of patients. This condition is stopped by drugs.

When a recurring juice appears, there is a likelihood of a recurrence of the pathological condition, since allergens unknown to them affect the patient's body.

Episodes

Whatever the anaphylactic shock, the emergency care algorithm should always be followed. In this case, specialists distinguish the following episodes of this condition:

1. "Harbingers." Dizziness, weakness in the body are observed. There is nausea and headache. Many patients have allergies on the mucous membranes and on the skin. Discomfort and a feeling of anxiety may occur. The patient complains of difficulty breathing, hearing loss, loss of vision, numbness of the limbs.
2. "High". With allergies, blood pressure decreases, so a person loses consciousness. The skin will have a painful pallor, tachycardia is observed, a sticky cold sweat is released. A person will breathe noisily, cyanosis of the limbs and lips appears, severe itching. There will be problems with urination or incontinence.
3. "Exit from the shock state." This stage can last several days. With allergies, weakness, lack of appetite, and dizziness are observed.

Forms

In modern medicine, 5 clinical forms of a pathological condition have been established:

1. Asphytic. Respiratory failure appears, bronchospasm may occur. Under these conditions, the voice becomes hoarse, breathing is complicated, shortness of breath is likely. At this stage, Quincke's edema is often observed. It is dangerous because a person’s breathing may overlap.
2. Abdominal. There is abdominal pain. Sometimes it is intense, which is confused with symptoms of acute appendicitis or ulcerative pathology. The vomiting reflex can be activated, defecation is disturbed.
3. Cerebral This form of pathology is dangerous in that it can manifest as swelling of the brain and its membranes. With this process, cramps are possible. The occurrence of severe nausea, falling into a stupor or coma is likely.
4. Hemodynamic. It is characterized by pain in the heart, a drop in pressure.
5. Generalized. The form appears in many victims. Common symptoms are observed.

With anaphylactic shock, the algorithm of first aid measures can improve a person’s condition. If help is timely, it saves life.

First aid

If anaphylactic shock occurs, the emergency procedure is as follows:

1. The patient is placed on the floor, table, sofa, etc. A folded blanket or other object must be placed under the legs, they should be raised.
2. To prevent the entry of vomit into the respiratory tract, the patient's head is turned to one side. If there are dentures instead of their teeth, they must be removed from the mouth.
3. If the attack happened indoors, then you need fresh air. You should open the doors and windows, unfasten the collar.
4. It is required to stop the patient's contact with the allergen, if any.
5. We need to count the pulse. If it is not palpable on the wrist, try to find it on the femoral or carotid artery.
6. If there is no result, an urgent cardiac massage (indirect) is required. It is performed as follows: the hands are folded into the lock, and then in this position they are placed on the sternum (middle). Then it is necessary to carry out tremors rhythmically (depth not more than 4-5 cm.).
7. It is necessary to check the breath of an allergic person. If the movements of the chest are invisible, then it is necessary to attach a mirror to his mouth or nose, which, in the presence of breathing, fogs up. If this does not happen, put a handkerchief on your open mouth and blow air through it.
8. It is required to immediately call for help or take the patient to a medical facility on their own. Before admission to doctors, a person is given an antihistamine or intramuscularly injected with adrenaline.

Medical assistance

With anaphylactic shock, an algorithm for emergency medical assistance is also necessary. To do this faster, urgent diagnostic measures are required. To differentiate this condition from other pathologies, specialists need to perform the correct medical history collection. An enzyme-linked immunosorbent and blood test, radiography, kidney and allergological tests are also performed.

The medical algorithm for first aid for anaphylactic shock is as follows:

1. The specialist measures the pressure and checks the heart rate.
2. Then determine oxygen saturation, conduct electrocardiography.
3. To ensure airway, the specialist should proceed as follows. In the presence of a gag reflex from the oral cavity, it is necessary to extract the remnants of the vomit. The jaw (lower) is removed by the triple reception of Safar. Tracheal intubation is performed.
4. In the presence of Quincke's edema or spasm of the gap, the doctor performs a conicotomy. This procedure involves performing an incision in the larynx. It is produced for better air flow to the lungs in the area between 2 types of cartilage. The doctor may decide to have a tracheotomy. This manipulation is carried out only in a hospital, since it is necessary to conduct an exact dissection of the tracheal rings.

This is a first-aid algorithm that eliminates painful symptoms and greatly alleviates a person’s condition.

Medicines

A specialist with a medical education should administer drugs in a state of shock. The following medicines are used:

1. Adrenalin. Before injection create a solution. For this, adrenaline hydrochloride (1 ml.) Is mixed with 0.1% of the physical. solution (10 ml.). If the condition appeared from an insect bite, then the site must be chopped off with a diluted composition (injections are performed subcutaneously). Then up to 5 ml. this solution is administered intravenously. The rest of the diluted adrenaline is introduced into the vial with physical. solution (200 ml.) and put an injection intravenously. In this case, the doctor should monitor the pressure.
2. Glucocorticosteroids. Usually, specialists administer to allergy sufferers with shock “Prednisolone” (9-12 mg) or “Dexamethosone” (12-16 mg.).
3. Antihistamines. First, injections of Tavegil. Gradually there is a transfer to the tablet form of funds.
4. Inhalation of 40% oxygen. The rate of administration should not be higher than 7 liters. per minute.
5. Methylxanthines. Used for respiratory failure. Doctors administer aminophylline (5-10 ml), methylxanthines (2.40%).
6. The solutions are crystalloid and colloidal. They are used if acute vascular insufficiency is present.
7. Diuretics Used to protect against brain edema. For example, Minnitol.
8. Anticonvulsants Effective in cerebral pathology.

Effects

When it turned out to bring a person out of shock, such conditions can persist for a long time:

• fever
• inhibitions;
• pain in the abdomen or heart, muscles, joints;
• lethargy;
• shortness of breath
• weaknesses;
• nausea
• gag reflex.

Prevention

To protect against anaphylactic shock, the following preventive measures are required:

1. Exclusion of contact with allergens.
2. Rejection of bad habits.
3. If treatment with drugs is performed, then their quality must be checked.
4. It is advisable to relocate if the housing is located in an environmentally disadvantaged area.
5. It is necessary to timely treat allergies associated with allergies.
6. It is important for patients to observe personal hygiene.
7. In the living room you need to regularly clean and ventilate.

ACS

This term means acute coronary syndrome, which is dangerous for humans. In this case, the blood flow of the artery that feeds the heart decreases so that a larger or smaller portion of the myocardium stops working normally or dies. The diagnosis is made during the day when doctors identify that this is an unstable angina pectoris or the onset of myocardial infarction. During this period, doctors take measures to restore patency of the damaged artery.

Emergency care for ACS - the algorithm of actions is as follows:

1. It is necessary to lay the person so that the head and shoulders are raised.
2. Clothing and belt are unfastened for better breathing.
3. In the absence of pulmonary edema, give aspirin tablets (2-3 pcs.). They must be chewed. So a thrombus can be dissolved, which blocked the lumen of the artery that feeds the heart.
4. Open windows or windows.
5. When the pressure exceeds 90/60 mm RT. Art., a person is given nitroglycerin (1 tablet) under the tongue. Secondarily, it is provided twice, after 5-10 minutes. Even if the pain has disappeared, you should not refuse hospitalization.
6. If beta-blockers were taken, then aspirin is given in the amount of 1 tablet.
7. When using antiarrhythmic drugs, a rhythm disturbance is observed, they take the appropriate medication. In parallel, the patient begins to cough deeply and severely before the arrival of the ambulance.
8. If the patient feels fear, panic, you should reassure him with words.
9. With convulsions, it is necessary to restore airway patency. You should take the corners of the lower jaw and under the chin, move the lower jaw so that the lower teeth are in front of the upper. In this position, perform artificial respiration by mouth to nose.
10. It is necessary to systematically check the pulse.
11. You should find ECG films and the means that a person takes to show this to doctors.

With ACS, the emergency algorithm is quite simple. Before the ambulance arrives, he is able to significantly alleviate the patient's condition.

ONMK

In shock conditions, there is a likelihood of acute cerebrovascular accident (stroke). The emergency algorithm is as follows:

1. It is necessary to call a doctor.
2. The patient is laid on his side. With vomiting, mechanical cleaning of the oral cavity is performed.
3. It is important to control the rhythm of breathing, hemodynamics (pressure, pulse, NPV). It is necessary to ensure the flow of air.
4. If necessary, a duct is introduced.
5. If the pressure is more than 200 mm RT. Art., then clonidine is administered intravenously - 0.5-1.0 to 10-0.9% saline.
6. With arterial hypotension, saline solutions or 5% glucose are injected intravenously.
7. If convulsions or psychomotor agitation is present, 2-4.2 ml of Relanium is administered intravenously or intramuscularly.
8. With severe vomiting, 2.0 ml of Cerucal is also administered. With severe headache - 2-4.0 ml of dipyrone 50%.

Thus, timely help with anaphylactic shock is important. This allows you to quickly alleviate the condition of a person, as well as save his life.