Anaphylaxis medical emergency and how to manage it. Anaphylactic shock management.

1. EMERGENCY MANAGEMENT
OF ANAPHYLACTIC SHOCK
PRESENTED BY
HIBA HAMID
GROUP C

2. What is anaphylaxis??
A manifestation of immediate
hypersensitivity in which exposure of a
sensitized individual to a specific antigen
results in life-threatening respiratory
distress, usually followed by vascular
collapse and shock, accompanied by
pruritis, urticaria, and angioedema.

3. • Medications, including antibiotics (especially
penicillin and sulfa), vaccines, opiates, aspirin,
NSAIDs, local anesthetics, intravenous fluids with
dextran, and insulin
• Foods, such as nuts, milk, eggs, soy, wheat, and
seafood
• Stings by fire ants and Hymenoptera species (eg,
bees, wasps, yellow jackets, hornets)
• Latex
• Blood products, including plasma, immunoglobulin,
cryoprecipitate, and whole blood
• Idiopathic origins
• Exercise
causes

4. Physiology of anaphylactic shock
• Anaphylaxis occurs only in those people who have previously
been exposed to the allergen.
• Patient is exposed to the allergen, an incubation period
follows, antibodies are formed. When the patient is exposed to
the same allergen, anaphylactic reaction occurs, sometimes
called the exciting or shock dose.

5. Signs and symptoms
• Signs and symptoms most commonly seen in the skin, gastro-intestinal,
respiratory, or circulatory systems.
• A common term used to describe these signs and symptoms is shock.
• Signs and symptoms associated with skin:
 Generalized pruritus (itching)
 Urticaria
 Angioedema
• These signs and symptoms are not too dangerous, but they do have the
potential to become life-threatening if they are located in some specific
areas.
• Angioedema around the mouth or throat could cause death from airway
obstruction.

6. Gastro-intestinal symptoms:
• Varying degrees of nausea, vomiting, and diarrhea
Respiratory symptoms:
• Sneezing, cough, weakness, tightness in chest, bronchospasm as
well.
• Varying degrees of airway obstruction
• Most often due to laryngeal edema, a swelling of the larynx that
occurs as a result of an allergic reaction.
• The swelling may be great enough to cause partial or complete
obstruction of the airway.
• The most common cause of death in anaphylactic reactions.

7. Circulatory symptoms:
• May include hypotension, shock, cardiac arrhythmias, and even complete
circulatory collapse.
• Also pallor, syncope, tachycardia, and palpitations.

8. • Diagnosis would be relatively much easier of the signs and
symptoms occur immediately after exposure.
• In this situation, almost immediately the patient would feel faint and
weak, would begin sweating, and will become anxious and restless
• The patient then develops severe itching sensation as a result of
allergic skin reactions. The condition then proceeds through the
gastro-intestinal, respiratory, and circulatory stages.
• If the cycle is not stopped, the end result would be death.
• One distinct problem with anaphylactic shock is that, in some cases,
the reaction can be so severe that all the signs and symptoms occur
at once. In these situations, diagnosis may be more difficult, and
death may occur regardless of any treatment.

9. treatment
Patient with obvious signs and
symptoms
• Summon medical assistance
• Place patient in a supine position
• Administer oxygen
• Administer epinephrine (Initial
doses for the management of
anaphylaxis are 0.3 to 0.5 mg
intramuscularly or 0.1 mg
intravenously. These doses should
be repeated as necessary until
resolution of the event)
• Administer anti-histamine as
needed
• Initiate CPR if necessary

10. Patient without signs and symptoms
• Summon medical assistance
• Do not administer epinephrine
• Place patient in Trendelenburg position
• Provide basic life support as needed
• Administer oxygen
• Initiate CPR if necessary
• Perform emergency cricothyrotomy if
necessary