Anaphylactic shock emergency symptoms. Anaphylactic shock: symptoms, emergency care, prevention. To eliminate these consequences, the patient is prescribed

According to statistics, the number of allergic diseases among the population is increasing every year. There has also been an increase in the number of patients with acute allergic reactions and conditions that are life-threatening and require urgent medical care. Treatment is most difficult anaphylactic shock– the most complex acute systemic response of the body to repeated introduction of an allergen. In this condition, all vital organs and systems suffer, and if you do not start providing assistance on time, the patient can be lost.

The first step in case of anaphylactic shock is to stop taking the drugs that caused the development of this process. If the needle is in a vein, the syringe must be disconnected and therapy continued through it. When the problem was caused by an insect bite, simply remove the sting.

Next, you should note the time when the allergen entered the body. It is important to pay attention to complaints, consider them first clinical manifestations. After which the victim must be laid down, while raising his limbs. The head should be turned to the side, the lower jaw pushed forward. This will prevent tongue retraction and possible aspiration of vomit. If a person has dentures, they are also removed. It is necessary to assess the patient's condition and listen to complaints. Pulse, blood pressure and temperature should be measured. The nature of shortness of breath is assessed. After which the skin is examined. If blood pressure has dropped by about 20%, there is a chance of developing shock.

A person needs to have full access to oxygen. Next, a tourniquet is applied for 20 minutes. The drug will be administered at that location. Ice should be placed at the injection site. Injections should be made exclusively with syringes or systems. This will prevent the problem from reoccurring.

If administration is carried out through the nose or eyes, they must be rinsed thoroughly. Then add a couple of drops of adrenaline. If the injection is subcutaneous, it is worth injecting the patient with 0.1% adrenaline solutions. Naturally, it needs to be diluted in saline solution. Until the doctor will come, you need to prepare the system. A person needs to be given 400 ml of saline intravenously. At the doctor’s command, a 0.1% adrenaline solution is slowly administered. If puncture is difficult, the agent is injected into soft fabrics, which are located in the sublingual area.

Glucocorticosteroids are injected in a stream and then by drip. Usually 90-120 mg of Prednisolone is used. Next, they resort to using a 1% Diphenhydramine solution or Tavegil solution. All this is administered intramuscularly. If bronchospasm occurs, Eufillin 2.4%, about 10 ml, is prescribed intravenously. If weakening of breathing has developed, then Cordiamine 25%, about 2 ml. For bradycardia, Atropine Sulfate, 0.1% - 0.5 ml is administered.

Goal of treatment for anaphylactic shock

Anaphylaxis is an acute borderline condition that does not go away on its own. If you do not immediately provide assistance to the patient, then a fatal outcome is inevitable.

Shock occurs more often during the patient's second contact with a substance to which the body is hypersensitive (allergic). This condition can be triggered by a variety of allergens of protein or polysaccharide origin, as well as special compounds that become allergens after their contact with human proteins.

Allergenic components that can cause an acute reaction may enter the body through digestive system, through breathing, skin, etc. The most common allergens are:

An important and first stage of treatment is to identify the allergen that triggered the reaction and interrupt contact with it.

Medicines to treat anaphylactic shock

A list of medications that may be needed to help a patient in anaphylactic shock may look like this:

• anti-shock hormonal drug Prednisolone - from the first second of administration it begins to act, reducing the manifestations of shock;
• an antihistamine - for example, Suprastin or Tavegil - eliminates the sensitivity of receptors to histamine, which is the main substance released into the blood in response to an allergic reaction;
• hormonal substance Adrenaline - necessary to stabilize cardiac activity in extreme conditions;
• Eufillin is a medication that provides respiratory function during a state of shock;
• antihistamine Diphenhydramine, which has a dual effect: it blocks the development of an allergic reaction and suppresses excessive stimulation of the central nervous system.

In addition to medications, syringes of various sizes should be on hand, medical alcohol for wiping the skin when injecting drugs, cotton balls, gauze, rubber band, bottles with sterile saline solution for intravenous infusions.

Drug treatment should be lightning fast. Be sure to administer the drugs intravenously, this will speed up their effect on the human body. The list of input funds should be limited. But despite this, certain drugs must be included in it.

• Catecholamines. The main one of this group of medications is Adrenaline. Due to a certain stimulation of adrenergic receptors, it will constrict blood vessels and also reduce myocardial activity. In addition, Adrenaline significantly increases cardiac output and also has a bronchodilator effect. It should be administered in the amount of 0.3-0.5 ml of 0.1%. It can be administered as a mixture. Typically it consists of 1 ml of a 0.1% solution of adrenaline and a solution of sodium chloride, in a volume of 10 ml. Possibly repeated administration within 5-10 minutes.
• Glucocorticosteroids. Prednisolone, Dexamethasone, Methyprednisolone, Hydrocortisone are mainly used. They are administered at the rate of 20-30 mg of the drug per kilogram of weight. This will help establish positive dynamics for the patient. Drugs in this category can significantly inhibit the effect of allergens on capillaries, thereby reducing their permeability.
• Bronchodilators. Among them, Eufillin is actively used. It allows you to reduce the release of histamine metabolites, thereby relieving bronchospasm. It should be administered intravenously at a dosage of 5-6 mg/kg over 20 minutes. If there is an urgent need, the administration is repeated, thereby moving to a maintenance dose of 0.9 mg/kg/h.
• Infusion therapy. It consists of administering 0.9 sodium chloride solution, acesol, 5% glucose solution. Due to them, the volume of blood circulation increases significantly and a vasoconstrictor effect occurs.
• Antihyapamine drugs. Drugs in this group can effectively affect a person’s condition. Prevent or completely eliminate angioedema and urticaria. They are able to reduce the effect of Histamine on the body. This leads to relief of attacks of anaphylactic shock. It is enough to simply inject 1-2 ml of Tavegil or Suprastin solution.

Treatment protocol for anaphylactic shock

In addition to the standard treatment protocol, there is also an auxiliary treatment regimen that is used in case of complicated anaphylaxis. To relieve laryngeal edema, for example, the above-mentioned drugs and funds will not be enough. Here you will need surgical intervention– tracheostomy. This operation involves placing a tracheostomy (a special tube for breathing) through an opening in the trachea. Additional local anesthetic drugs are used simultaneously with the operation.

If state of shock occurs with prolonged loss of consciousness, and there is also a threat of developing a coma, the doctor can use a standard set of anti-shock therapy.

Normalization of the patient's condition and elimination of danger is recorded using special analyzes and studies characterizing the restoration of vital functionality important organs, in particular, the liver and urinary system.

If shock was provoked by the administration of a drug, then this must be recorded in the patient’s medical history and medical card. In this case, all drugs of the group that caused the allergic reaction must be indicated. The entry must be visible at first glance, so it is written with a red marker on the title page of the card. This is done primarily in order to have an idea of ​​what kind of assistance should be provided to the patient if he is unconscious.

Treatment algorithm for anaphylactic shock

The algorithm for helping with the development of anaphylactic shock consists of blocking the effect of the allergenic substance on the body and combating the main symptoms of the shock state.

At the first stage, measures are taken to help restore the function of all organs and systems of the patient. For this reason, hormonal drugs are considered the most important drugs for anaphylaxis:

• the use of Adrenaline allows you to narrow the lumen of peripheral vessels, thereby inhibiting the movement of histamine secreted by the immune system throughout the body;
• Prednisolone use calms immune activity that can lead to cardiac arrest.

After urgently important events the second stage of treatment is prescribed - eliminating the consequences of the shock state. As a rule, almost all patients require further medical treatment after emergency care.

In extraordinary dire situations the list medicines, which are used for anaphylactic shock, are obviously expanded, including the required resuscitation measures.

Treatment of anaphylactic shock at the prehospital stage

Since anaphylactic shock is considered an immediate threat to the patient’s life, emergency measures should be provided immediately and as quickly as possible. Treatment can be divided into initial (prehospital) and inpatient treatment.

What does the pre-hospital treatment stage include?

1. Intramuscular urgent administration of Epinephrine (Adrenaline hydrochloride) to all victims without exception with signs of anaphylaxis. The drug is injected into the upper half of the body (for example, into the superficial shoulder muscle). The dosage of the drug for an adult patient is 0.5 ml of 0.1% solution. If necessary, the injection is repeated after 5 minutes. Intravenous infusion of adrenaline is used only in extreme cases, in cases of deep shock or clinical death, or in cases where shock has developed against the background general anesthesia. For patients whose condition has not improved with the administration of adrenaline, Glucagon is administered, 1-2 mg intravenously or intramuscularly every 5 minutes, until a visible positive effect is achieved.
2. Intensive administration of fluids. When the “upper” pressure is less than 90 mm Hg. Art. use a jet injection (up to 500 ml in 20-30 minutes), then switching to a drip, isotonic sodium chloride solution (800-1200 ml) with the further connection of Polyglucin (400 ml). Simultaneously with the administration, blood pressure and diuresis are monitored.
3. Easier breathing. To improve the patency of the trachea and bronchi, accumulated mucus is aspirated and pure oxygen is administered by inhalation. If necessary, tracheostomy is performed with further use of a mechanical ventilation device.

Non-drug treatment of anaphylactic shock is carried out before the ambulance arrives and consists of the following measures:

• blocking the entry of the allergen into the body;
• ensuring the patient is in a horizontal position with the head turned to the side and down;
• applying a tourniquet over the injection site of an allergen or insect bite;
• if necessary, artificial heart massage and artificial ventilation.

Treatment in hospital

A further set of measures does not directly affect the course of the shock state, but with its help it is possible to reduce anaphylactic symptoms, speed up the recovery of the body and prevent a possible relapse.

• Corticosteroids are not emergency medications. Their effectiveness appears on average only 5 hours after intravenous injection. However, the benefits of corticosteroids are great: they can prevent or shorten the duration of phase II of anaphylaxis. In this case, drugs such as Hydrocortisone in an amount of 125-250 mg, or Dexazone in an amount of 8 mg are administered intravenously. It is recommended to repeat such administrations every 4 hours until the acute reaction subsides.
• Antihistamines should be used after stabilization of blood circulation, because one of the side effects Such drugs lower blood pressure. Diphenhydramine is administered intravenously from 20 to 50 mg, or intramuscularly from 2 to five ml of a 1% solution. The administration can be repeated after 5 hours. At the same time, intravenous administration of Ranitidine (50 mg) or Cimetidine (200 mg) is recommended.
• Bronchodilator drugs are used in the presence of bronchospasm that is not eliminated by the administration of Adrenaline. As a rule, to restore respiratory function, Salbutamol is used in an amount of 2.5-5 mg, with the possibility repeated administrations drug. The reserve drug in this case is Eufillin (intravenously in the amount of 6 mg per kilogram of patient weight).

Treatment of anaphylactic shock in children

TO therapeutic measures they begin as soon as possible, already if anaphylaxis is suspected, without waiting for the full development of symptoms. Sending the child to the hospital is mandatory.

The first step is to prevent the allergen from entering the body. Next, 0.1% adrenaline is administered subcutaneously or intramuscularly (the dose is calculated depending on the age and weight of the baby). Cold is applied to the suspected area of ​​contact with the allergenic substance.

An urgent administration of corticosteroids is started: Dexamethasone, Prednisolone or Hydrocortisone.

If an allergenic substance enters the body with food, then emergency gastric lavage should be performed, followed by the administration of sorbent preparations ( Activated carbon or Enterosgel).

On prehospital stage others and parents can help next help to kid:

• prevent the allergen from entering the body;
• place the child slightly on his side and head down - this improves blood circulation in the brain and reduces the risk of inhaling vomit;
• if necessary, fix the tongue;
• provide access to clean air;
• urgently call “emergency” or any health worker;
• If necessary, perform artificial respiration.

Treatment after anaphylactic shock

After anaphylaxis, patients require treatment with glucocorticoids for one to three weeks. Treatment begins with 50 mg of prednisolone. The dose depends on the complexity of the condition and the presence of complications, the patient’s age, test results, etc. It is necessary to take into account all the nuances in order to prevent late complications in the functioning of the organs and systems of the body.

Patients who have experienced anaphylactic shock should be aware in the future that there is a serious risk to their lives of repeated anaphylaxis. They must be extremely careful about the possible re-introduction of the allergen into the body.

The attending physician must indicate in the medical history and extract the substance or medication that caused the anaphylactic reaction in the body. A final consultation with an allergist is mandatory.

The patient is discharged from the hospital only after stabilization of blood tests, urine tests, cardiogram, and if digestive disorders– stool analysis.

New in the treatment of anaphylactic shock

Anaphylactic shock is a complex and responsible condition that very often leads to death. For this and other reasons, allergists are interested in finding new treatments for allergies.

• Use of medicinal radiation. A French immunologist has developed a method according to which not drugs are used to treat allergies, but their radiation in water. It turned out that medications can be replaced with “projections” that are fixed in the liquid. This method is striking in its seemingly unrealistic nature. However, more than two thousand tests have already been carried out, which have confirmed the effectiveness of the method.
• Method of autolymphocytotherapy. The essence of this technique is the introduction of the patient’s own lymphocyte mass, which has been pre-processed while preserving information about all contacts with allergens. This procedure makes the body immune to potential encounters with allergens.
• New Generation antihistamines. Experts from Finland have discovered that histamine substances (“allergy mediators”) can affect not only H1-histamine receptors. This conclusion can be used to develop new medical supplies. By the way, some of them are already undergoing clinical trials. For example, tryptase, chymase, cathepsin G are enzymatic substances that break down certain proteins. In addition, they are able to block H4 histamine receptors. It is likely that after some time we will be able to purchase combination drugs, aimed at inhibiting H1 and H4 histamine receptors, which in combination will give a more noticeable positive result.

Of course, medicine is moving by leaps and bounds in its developments. Both allergists and immunologists, as well as patients, sincerely hope that scientists will soon find the latest successful methods and means that can prevent allergies and treat anaphylactic shock quickly and safely.

A year and a half has passed since the death of my good friend. And the reason is banal - allergic reaction to the drug, instantly developing anaphylactic shock and death. It is clear that no one is immune from this. But I always want there to be as few such ridiculous deaths as possible. And it’s doubly a pity, because he was a young guy and just good man. There are simply few such people...

What is anaphylactic shock?

Anaphylactic shock is the highest manifestation of an allergic reaction. As a rule, anaphylactic shock occurs when a provoking substance enters the body of a person prone to allergies. Moreover, as a rule, such a violent reaction of the body occurs when this substance enters the body again. While reading annotations for various medications, you have probably come across a name such as anaphylactic shock. This phenomenon is not very common, but still, anaphylactic shock can occur in any person. As a child, almost all of us were bitten by some kind of insect - a wasp or a bee. Of course, we all remember that it is very painful. However, most often we got away with a slight fright and minor discomfort: the sting was removed, the wound was washed, the antiallergic tablet was taken, it hurt for a while, and then went away. But not always acquaintance with insects can end happily. After being bitten by some insects, a person may swell, suffocate, lose consciousness and, if first aid cannot be provided, die. It would seem like a harmless bite - what's wrong with that? Sometimes, as a result of such a “harmless” bite, anaphylactic shock can develop.

Why does anaphylactic shock occur?

Our body is a clearly functioning autonomous system. If any foreign substance (germs, particles of drugs, toxic substances, viruses, infections, etc.) gets into it, the body begins to produce special substances against it - antibodies. By binding to the antigen, antibodies help remove the foreign object from the body. In some cases, the body, in response to the introduction of a foreign object, reacts very violently and produces a huge amount of antibodies, much more than is required. Antibodies settle on tissues and organs and are activated upon repeated administration of this antigen. When an antigen combines with an antibody, a number of biologically active substances(histamine, serotonin, bradykinin), which cause increased permeability of blood vessels, impaired blood circulation in small blood vessels, spasm of the muscles of internal organs and a number of other disorders. This promotes the release of the liquid part of the blood into the tissues and the thickening of the blood. Blood accumulates in the periphery, internal organs and the brain do not receive enough oxygen. Constriction occurs respiratory tract in the lungs, wheezing occurs, blood vessels expand and blood pressure decreases, the walls of blood vessels begin to leak fluid and swelling occurs, the heart begins to malfunction and pumps blood worse.

What substances can trigger anaphylactic shock?

These are various medications, such as non-steroidal anti-inflammatory drugs, vaccines, vitamins, some antibiotics and others. In addition, anaphylactic shock can cause insect poisoning. There is evidence that even certain foods can trigger anaphylactic shock. But this is very severe allergies on them or in case of increased action by other allergens.

Who gets anaphylactic shock?

Anaphylactic shock, unfortunately, can happen to each of us, but if you have never suffered from allergies, then your chance is minimal. In addition, adult women are more susceptible to this condition. In children, anaphylactic shock is a fairly rare occurrence. If you are allergic to medications, be careful. On average, fifteen percent of these drug allergies are fatal.

How quickly does anaphylactic shock develop?

It's very individual. Sometimes a serious condition can begin to manifest itself within a couple of minutes. And sometimes this takes several hours. Moreover, the duration of this period is not at all affected by the amount of substance that enters the allergic person’s body. But the amount of the substance affects the course of anaphylactic shock. The higher the dose, the more severe and longer person suffers shock. Anaphylactic shock can develop even when performing an allergy test. Every person suffering from allergies has at least once done such a test, when small scratches are made on the skin and substances - allergens - are applied to them. So, if this test is carried out using the allergens themselves, then it can provoke the development of anaphylactic shock.

How does anaphylactic shock occur?

Anaphylactic shock is quite difficult to confuse with anything else. It always develops very quickly. There are several degrees of shock: mild, moderate and severe. In addition, the symptoms depend on how damaged the brain vessels are from lack of oxygen. With mild anaphylactic shock, patients complain of general malaise, allergic manifestations such as sneezing, swelling, itching of the skin. With such a degree of anaphylactic shock, a decrease in blood pressure and a disturbance in the rhythm of cardiac activity are necessary. With moderate severity, the patient’s condition worsens significantly, his heart hurts, he sweats profusely, weakens before his eyes, the mucous membranes of the mouth become inflamed, and his limbs may tremble. Sometimes there are also disturbances in the functioning of the digestive organs and spontaneous urination. The most complex shape anaphylactic shock develops very quickly. The person turns pale and faints, the pressure drops, and breathing stops. The course of anaphylactic shock varies greatly among different people. Some people's skin may suffer more. In this case, the patient complains of itching, rashes, swelling and redness. For others, anaphylactic shock affects brain function. This is immediately a severe headache, vomiting, muscle contractions, urinary and fecal incontinence, and fainting.

What is the treatment for anaphylactic shock?

Because anaphylactic shock is a medical emergency, a person who experiences anaphylactic shock has a very high chance of experiencing it again. Such people must have a syringe with adrenaline with them in case of relapse, because Adrenaline helps relieve the symptoms of incipient anaphylactic shock and prevent collapse. However, after the administration of epinephrine, the person still needs to be transported to medical institution and provide assistance. Anaphylactic shock is dangerous not only because there is a very high probability of death. If you are prone to allergic reactions, always have other medications with you: any antihistamines (suprastin, tavegil) and hormonal medications (prednisone, dexamethasone), preferably by injection. First medical aid to a person in a state of anaphylactic shock must be carried out clearly, quickly, and in the correct sequence.

1. Immediately stop the administration of the allergen that caused the reaction, lay the patient down (head below the feet), turn the head to the side, extend the lower jaw, remove existing dentures.
2. If the injection or bite was made into a limb, a tourniquet must be applied above the site of injection of the allergen.
3. Sublingually into the frenulum of the tongue, intravenously or intramuscularly, inject a 0.1% solution of adrenaline 0.3-0.5 ml; for intravenous administration, adrenaline must be diluted in saline solution.
4. Apply 0.3-0.5 ml of 0.1% adrenaline solution to the injection site.
5. Apply an ice pack to the injection site.
6. Urgently call a doctor by phone, and at the same time call the resuscitation team.

- this is, as a rule, an acute systemic allergic reaction, which is characterized by rapid development with signs and sharp decrease in pressure . Severe cardiovascular disease and is life-threatening for the patient.

The cause of anaphylactic shock is due to repeated contact with the allergen. The development of the reaction depends on the sensitivity of the body. So, in some cases, the reaction occurs within two minutes after contact, but it can develop within several hours. Very often, anaphylactic shock occurs when , when taking protein foods or administering medications that were previously observed .

The differences between anaphylactic shock and similar allergic reactions are its systemic nature, that is, the involvement of several organs, and the severity of the disease. Without timely help, such reactions end in death. Anaphylactic shock as a complication drug allergies arises on , anesthetics, non-steroidal anti-inflammatory drugs, vaccines, radiocontrast agents. Illness may occur even when testing these medications for a reaction.

Symptoms of anaphylactic shock

Typically, anaphylactic shock is characterized by the fact that its symptoms appear alternately. Typically, the first visual symptoms are hives , although in some cases there may be no urticaria. Next, hoarse “asthmatic” breathing and cough appear, as a consequence of the rapidly developing broncho - And laryngospasm , development and progression is possible. Also, blood pressure drops sharply and suddenly.

Very often these appear general symptoms anaphylactic shock such as a feeling of heat, difficulty breathing, pain in the head and in the chest area. During a reaction, a person is excited and restless, but in rare cases he may also be lethargic and depressed. It is worth noting that depending on how the development of this pathological condition the patient may experience muscle cramps.

Emergency care for anaphylactic shock

The first thing to do, in view of the possibility, is to urgently stop the flow of allergen into the body. For example, if an allergy develops due to an insect bite, then it would be advisable to apply a tourniquet just above the bite site 1-2 cm and apply ice to the entry point of the insect sting. This significantly stops the flow of the allergen into the general blood stream and slows down the process of development of anaphylactic shock. An ambulance team is urgently called, and in the meantime the patient is placed in a supine position and freed from oppressive and constrictive clothing (tie, collars), thereby ensuring access to oxygen. If vomiting is possible, the patient's head should be turned to one side to prevent aspiration due to recessed tongue or vomit.

Treatment of anaphylactic shock

Treatment for anaphylactic shock, just like other allergic conditions, is symptomatic. To the patient parenterally , that is, subcutaneously, and best of all, from 0.2 ml to 0.5 ml of 0.1% in the form of hydrochloride (adrenaline solution) is administered intravenously. This is the first urgent Care with anaphylactic shock, so people prone to allergies should have this medicine with them. If necessary, you can repeat the injections, but be sure to monitor your heart rate and breathing.

Following the above drug, glucocorticoids , for example at a dosage of 150 mg. Also necessary in such a process as adequate treatment of anaphylactic shock is the use of antihistamines, that is, those that reduce the allergic reaction. The list of these drugs includes

Anaphylactic shock: the most severe manifestation of an allergic reaction that threatens life.

Anaphylaxis– a rapidly developing allergic reaction that threatens life, often manifests itself in the form of anaphylactic shock. The term “anaphylaxis” literally translates as “against the immune system.” From Greek " A" - against and " phylaxis" – protection or immunity. The term was first mentioned more than 4,000 years ago.

• The incidence of anaphylactic reactions per year in Europe is 1-3 cases per 10,000 population, mortality is up to 2% among all patients with anaphylaxis.
• In Russia, of all anaphylactic reactions, 4.4% manifest as anaphylactic shock.

What is an allergen?

• Inhalation (aeroallergens) or those that enter the body through the respiratory tract (plant pollen, mold spores, house dust and etc.);
• Food (eggs, honey, nuts, etc.);
• Insect or insect allergens (cockroaches, moths, moth flies, beetles, etc., allergens contained in the poison and saliva of insects such as bees, wasps, hornets are especially dangerous);
• Animal allergens (cats, dogs, etc.);
• Drug allergens (antibiotics, anesthetics, etc.);
• Occupational allergens (wood, grain dust, nickel salts, formaldehyde, etc.).

Immunity status for allergies

Mechanism of development of anaphylaxis

The development of an allergic reaction can be divided into several stages:

1. Sensitization or allergization of the body. A process in which the body becomes very sensitive to the perception of a particular substance (allergen) and when such a substance enters the body again, an allergic reaction occurs. When an allergen first enters the body by the immune system, it is recognized as a foreign substance and specific proteins are produced to it (immunoglobulins E, G). Which are subsequently fixed on immune cells (mast cells). Thus, after the production of such proteins, the body becomes sensitized. That is, if the allergen enters the body again, an allergic reaction will occur. Sensitization or allergization of the body is the result of a failure of the normal functioning of the immune system caused by various factors. Such factors may be hereditary predisposition, prolonged contact with the allergen, stressful situations, etc.
2. Allergic reaction. When an allergen enters the body for the second time, it is immediately met by immune cells, which already have previously formed specific proteins (receptors). After the allergen comes into contact with such a receptor, special substances are released from the immune cell that trigger an allergic reaction. One of these substances is histamine - the main substance of allergy and inflammation, which causes vasodilation, itching, swelling, subsequently impaired breathing, and decreased blood pressure. In anaphylactic shock, the release of such substances is massive, which significantly disrupts the functioning of vital organs and systems. Such a process in anaphylactic shock without timely medical intervention is irreversible and leads to the death of the body.

Risk factors for developing anaphylactic shock

4. Aeroallergens

• The development of an anaphylactic reaction when an allergen enters the respiratory tract occurs very rarely. However, during the pollen season, patients with high sensitivity to pollen may develop anaphylaxis.

• Cases of severe allergic reactions to the administration of vaccines against influenza, measles, rubella, tetanus, mumps, and whooping cough have been described. It is assumed that the development of reactions is associated with vaccine components, such as gelatin, neomycin.

• Anaphylactic shock can be caused by a blood transfusion, but such reactions are very rare.

• Exercise-induced anaphylaxis is a rare form of anaphylactic reaction and comes in two types. The first, in which anaphylaxis occurs due to physical activity and the use of foods or medications. The second form occurs during physical activity, regardless of food intake.

• Anaphylaxis can be a manifestation of a specific disease - systemic mastocytosis. A disease in which the body produces an excess number of specific immune cells (mast cells). Such cells contain a large number of biologically active substances that can cause an allergic reaction. A number of factors such as alcohol intake, medications, food products, bee stings can release these substances from cells and cause a severe anaphylactic reaction.

Symptoms of anaphylactic shock, photo

Various organs and systems are subsequently involved:

Organs and systems	Symptoms and their description	Photo
Skin and mucous membranes	Heat, itching, and rashes in the form of hives often occur on the skin of the inner thighs, palms, and soles. However, rashes can occur in any area of ​​the body. Swelling in the face, neck (lips, eyelids, larynx), swelling of the genitals and/or lower limbs. With rapidly developing anaphylactic shock, skin manifestations may be absent or occur later. 90% of anaphylactic reactions are accompanied by urticaria and swelling.
Respiratory system	Nasal congestion, mucous discharge from the nose, wheezing, cough, feeling of throat swelling, difficulty breathing, hoarseness. These symptoms occur in 50% of patients with anaphylaxis.
The cardiovascular system	Weakness, dizziness, decreased blood pressure, increased heart rate, chest pain, possible loss of consciousness. Damage to the cardiovascular system occurs in 30-35% of patients with anaphylactic shock.
Gastrointestinal tract	Swallowing disorders, nausea, vomiting, diarrhea, intestinal spasms, abdominal pain. Gastrointestinal disorders occur in 25-30% of patients with anaphylactic shock.
central nervous system	Headache, weakness, fog before the eyes, possible convulsions.

In what forms does anaphylactic shock most often develop?

Form	Development mechanism	External manifestations
Typical(most common)	When allergens enter the body, they trigger a number of immune processes, as a result of which a large amount of biologically active substances (histamine, bradykinin, etc.) are released into the blood. This mainly leads to vasodilation, decreased blood pressure, spasm and swelling of the airways. Disturbances quickly increase and lead to changes in the functioning of all organs and systems. At the onset of anaphylaxis, the patient feels heat in the body, rashes and itching of the skin appear, swelling in the face and neck is possible, dizziness, tinnitus, nausea, difficulty breathing appear, a drop in blood pressure leads to impaired consciousness, and convulsions are possible. Decrease in pressure down to 0-10 mmHg. All these symptoms are accompanied by a fear of death.
Asphyxial form (form with a predominance of respiratory failure)	With this form of anaphylaxis, symptoms of breathing problems come to the fore. After the allergen enters the body, a person feels nasal congestion, coughing, hoarseness, wheezing, a feeling of throat swelling, and difficulty breathing. Spasm of the larynx, bronchi, pulmonary edema develops, and subsequently respiratory failure increases. If measures are not taken in time, the patient dies from suffocation.
Gastrointestinal form	With this form, the main manifestations of anaphylaxis are abdominal pain, vomiting, and diarrhea. A harbinger of such a reaction may be itching in the mouth, swelling of the lips and tongue. The pressure is usually not lower than 70/30 mmHg.
Brain shape	In the cerebral form of anaphylaxis, the picture of the disease manifestation is dominated by disturbances from the central nervous system, impaired consciousness, convulsions due to cerebral edema.
Exercise-induced anaphylaxis	How separately exercise stress, and its combination with preliminary intake of foods or medications can cause the triggering of an anaphylactic reaction, up to anaphylactic shock. More often it manifests itself with itching, heat, redness, urticaria, swelling in the face, neck; with further progression, the gastrointestinal tract is involved, respiratory system, swelling of the larynx occurs, and blood pressure drops sharply.

How to determine the severity of anaphylactic shock?

First emergency aid for anaphylactic shock

1. Do I need to call an ambulance?

1. How can I help before the ambulance arrives?

• First of all, it is necessary to remove the source of the allergen. For example, remove the insect sting or stop administering the medicine.

• The patient must be placed on his back and his legs elevated.

• The patient's consciousness should be checked to see if it answers questions and if it reacts to mechanical stimulation.

• Clear the airways. Turn your head to the side and remove mucus from the mouth, foreign bodies, pull out the tongue (if the patient is unconscious). Next, you need to make sure that the patient is breathing.

• If there is no breathing or pulse, begin cardiopulmonary resuscitation. However, in cases of severe swelling and spasm of the airways, pulmonary ventilation before the administration of epinephrine may not be effective. Therefore, in such cases, only indirect cardiac massage is used. If there is a pulse, indirect cardiac massage is not performed!

• In emergency situations, a puncture or incision of the cricothyroid ligament is performed to open the airway.

Use of medications

1. Adrenalin
2. Hormones
3. Antihistamines

How to ensure airway patency during laryngeal edema?

Technique:

1. Definition of cricothyroid ligament or membrane. To do this, moving your finger along the front surface of the neck, the thyroid cartilage is determined (in men, the Adam's apple), immediately below it is the desired ligament. Below the ligament, another cartilage (cricoid) is defined; it is located in the form of a dense ring. Thus, between the two cartilages, the thyroid and cricoid, there is a space through which it is possible to provide emergency air access to the lungs. In women, it is more convenient to determine this space by moving from bottom to top, first finding the cricoid cartilage.

1. A puncture or puncture is carried out using what is at hand, ideally a wide puncture needle with a trocar, but in an emergency you can use a puncture with 5-6 needles with a large lumen or make a transverse incision of the ligament. A puncture or incision is made from top to bottom at an angle of 45 degrees. The needle is inserted at the moment when it becomes possible to draw air into the syringe or the feeling of falling into an empty space when advancing the needle. All manipulations should be done with sterile instruments; if they are not available, sterilize them over fire. The surface of the puncture should be pre-treated with an antiseptic and alcohol.

Treatment in hospital

• Eliminating contact with the allergen
• Treatment of acute disorders of the circulatory, respiratory and central nervous system. For this, epinephrine (adrenaline) 0.2 ml 0.1% is administered intramuscularly at intervals of 10-15 minutes; if there is no response, then the drug is administered intravenously (0.1 mg diluted 1:1000 in 10 ml NaCl).
• Neutralization and stopping the production of biologically active substances (histamine, kallikrein, bradykinin, etc.). Glucocorticoids (prednisolone, dexamethasone) and antihistamines, H1 and H2 receptor blockers (suprastin, ranitidine, etc.) are administered.
• Detoxification of the body and replenishment of circulating blood volume. For this purpose, solutions of polyglucin, reopoluglucin, isotonic NaCl b solution, etc. are administered.
• According to indications, medications to eliminate spasms of the respiratory tract (aminophylline, aminophylline, albuterol, metaproterol) are administered for convulsions. anticonvulsants and etc.
• Keeping Vital important functions body, resuscitation actions. To maintain the pressure and pumping function of the heart, Dopamine is used, 400 mg in 500 ml of 5% dextrose solution intravenously. If necessary, the patient is transferred to an artificial respiration apparatus.
• All patients who have suffered anaphylactic shock are recommended to be under medical supervision for at least 14-21 days, as complications from the cardiovascular and urinary systems may develop.
• Mandatory general analysis blood, urine, ECG.

Prevention of anaphylactic shock

• Always have the necessary medications on hand. Know how to use an automatic injector for administering epinephrine (Epi-pen, Allerjet).
• Try to avoid insect bites (do not wear bright clothes, do not wear perfume, do not eat ripe fruits on the street).
• Learn to correctly evaluate information about the components of purchased products in order to avoid contact with allergens.
• If you have to eat outside the home, the patient must make sure that the dishes do not contain allergens.
• At work, contact with inhalant and skin allergens should be avoided.
• Patients with a severe anaphylactic reaction should not use beta blockers and, if necessary, should be replaced with drugs from another group.
• When conducting diagnostic studies X-ray contrast agents require preliminary administration of prednisolone or dexamethasone, diphenhydramine, ranitidine

Anaphylactic shock is an acutely developing process. It poses a great threat to human life and can lead to death. Much depends on the degree of the allergic attack and the disorders that it provoked. All symptoms, causes and treatment will be described in more detail below.

ICD-10 code

Anaphylactic shock belongs to the T78-T80 group. This includes both primary codes for identification and those due to an unidentified cause. In multiple coding, this category can be used as an additional code to identify the impact of conditions classified in other categories.

• T78.0 Anaphylactic shock caused by an abnormal reaction to food.
• T78.1 Other manifestations of pathological reactions to food.
• T78.2 Anaphylactic shock, unspecified.
• T78.3 Angioedema

Giant urticaria Quincke's edema. Excludes: urticaria (D50.-). whey (T80.6).

• T78.4 Allergy, unspecified

Allergic reaction NOS Increased sensitivity NOS Idiosyncrasy NOS Excludes: allergic reaction NOS to an adequately prescribed and correctly administered medicinal product (T88.7). T78.8 Other adverse reactions not elsewhere classified.

• T78.9 Unspecified adverse reaction.

Excludes: adverse reaction caused by surgery and medical intervention NOS (T88.9).

ICD-10 code

T78.2 Anaphylactic shock, unspecified

Statistics

Fortunately, situations where anaphylactic shock develops are not that common. According to statistics, a reaction while taking certain medications develops in only one person out of 2,700 hospitalized people. This is a very small figure. Fatalities are not that common. Typically, the mortality rate is 1-2 out of a million. This statistic is relevant for insect bites.

Statistical data regarding this pathology in different countries differs significantly from each other. As for Russia, the problem occurs in no more than one person out of 70 thousand per year. Basically, a reaction occurs when an insect bites, this is the most common reason for its appearance. In Canada this figure is lower, 4 cases per 10 million, in Germany 79 cases per 100 thousand (high). The problem is very common in the US. So, in 2003, the pathology affected 1,500 thousand people per year.

Causes of anaphylactic shock

The main reason is the penetration of poison into the body, this can happen due to a snake or insect bite. IN last years The problem began to appear while taking medications. Penicillin, Vitamin B1, Streptomycin can lead to this. Similar action caused by Analgin, Novocaine, immune serums.

• Poisons. Bites from bedbugs, wasps and bees can lead to pathology. This causes anaphylactic shock in particularly susceptible people.
• Medicines. The above medications can lead to shock. To alleviate a person’s condition, it is worth administering Prednisolone and Adrenaline. They will be able to relieve allergic reactions and swelling.
• Food. Most products can lead to the development of the problem. Simply eating the allergen is enough. These are mainly milk, eggs, peanuts, nuts, and sesame seeds.
• Risk factors. People suffering from asthma, eczema, and allergic rhinitis are more susceptible to developing shock. An allergic reaction can develop to latex and contrast agents.

Pathophysiology

The key moment of anaphylactic shock is a sharp drop in blood pressure. Like any allergic reaction, this pathology begins with an allergen-antibody reaction. There is no exact definition of why the disease occurs. This is a common allergic reaction that can occur to anything.

True, it has been proven that when an allergen enters the body, it begins an active reaction with antibodies. This triggers a whole series of cascading actions. As a result, capillaries and arteriovenous shunts expand.

Due to this negative effect, most of the blood begins to move from great vessels in the peripheral area. The result is a critical decrease in blood pressure. This action occurs so quickly that the circulatory center simply does not have time to quickly react to this process. As a result, the brain does not receive enough blood and the person loses consciousness. True, this measure is an extreme measure, as a rule, it leads to death. Not in all cases, but half of them definitely end unfavorably.

Symptoms of anaphylactic shock

The clinical picture of the disease is “famous” for its rapidity. Thus, symptoms develop within a few seconds after contact with the allergen occurs. The first thing that occurs is depression of consciousness, after which blood pressure drops sharply. The person suffers from cramps and involuntary urination occurs.

Before the main symptoms, many patients begin to feel a sharp rush of heat and skin flushing. In addition, the fear of death depresses, appears headache And painful sensations behind the sternum. Then the pressure drops and the pulse becomes thready.

There are other options for the development of anaphylactic shock. So, skin damage is possible. A person feels increasing itching, which is characteristic of Quincke's edema. After which a severe headache and nausea develop. Next, convulsions occur, accompanied by involuntary urination and defecation. Then the person loses consciousness.

The respiratory system is damaged, the person experiences suffocation caused by swelling of the mucous membrane. On the part of the heart, acute myocarditis or myocardial infarction is observed. Diagnosis is made by clinical manifestations.

Precursors of anaphylactic shock

After interaction with the allergen has occurred, the precursor stage develops. It is characterized by the appearance of a feeling of approaching death. The person begins to be plagued by discomfort, fear and anxiety. He cannot describe his condition. After all, it is really strange.

Then tinnitus begins to appear. Maybe a sharp decline vision, which brings a lot of discomfort. The person is in a pre-fainting state. Then lower back pain develops, and the fingers and toes begin to go numb. All these symptoms indicate that a person is developing anaphylactic shock. It is also characterized by the development of urticaria, Quincke's edema and severe itching.

It is important to understand that things are bad and it is necessary to provide emergency assistance to the person. If symptoms appear, you should contact medical institution. It is impossible to help a person without special preparation and the use of the necessary medications.

Drug-induced anaphylactic shock

Drug-induced anaphylactic shock is an acute allergic reaction that occurs immediately. It all occurs while taking medications. They squeeze out mediators and lead to disruption of important organs and systems. Which can be fatal.

A problem arises due to a history of drug allergies. Possible development due to long-term use medicinal substances, especially if they are characterized by repeated use. Depot medications, polypharmacy, and increased sensitizing activity of the drug can lead to shock. The risk is occupational contact with drugs, presence allergic disease history of dermatomycosis.

This pathology does not occur very often. This mainly happens due to self-treatment, without consulting a doctor or using a medication that can cause an allergy.

Anaphylactic shock in pregnant women

This phenomenon begins to gain momentum over time. Pregnancy itself makes a woman vulnerable to many factors, including allergic reactions. This condition is often caused by taking certain medications.

The clinical picture of manifestations is not at all different from the symptoms of anaphylactic shock in other people. However, this phenomenon in pregnant women can lead to spontaneous abortion or the onset of premature birth. This process can lead to premature placental abruption, which leads to fetal death. The development of disseminated intravascular coagulation syndrome cannot be ruled out. It is this that causes fatal uterine bleeding.

Particularly serious is the reaction that occurs along with loss of consciousness. A woman can simply die within 30 minutes. Sometimes this “process” is extended by 2 days or 12 days. It entails malfunctions in the functioning of vital organs and systems.

Treatment in this case is extremely difficult. After all, the role of the allergen itself is the fruit. If the woman's condition is serious, it is recommended to terminate the pregnancy. In general, a pregnant girl should take medications with caution so as not to provoke such a reaction in the body.

Anaphylactic shock in newborns

Anaphylactic shock is an allergic reaction that is immediate. That is, the condition worsens immediately after contact with the allergen. This can happen due to taking medications, as well as the use of X-ray contrast agents. Very rarely, the process occurs against the background of an insect bite. There have been cases where the “problem” was caused by cold. Most often the problem arises due to the negative effects of antibiotics. The reaction usually occurs to Penicillin. If a mother took such a drug and then breastfed her baby, the reaction will be immediate.

The baby begins to be bothered by a feeling of fear and anxiety. The child is capricious and crying. Blueness and pallor of the face are observed. Shortness of breath often begins, accompanied by vomiting and rash. The child’s blood pressure rises, but it is impossible to understand this without measuring it. After which loss of consciousness occurs and convulsions appear. Naturally, death is not excluded.

If the condition is accompanied by acute respiratory failure, then the baby develops severe weakness, lacks air, and has a painful cough. The skin suddenly turns pale, sometimes foam appears at the mouth, as well as wheezing. In children, everything manifests itself very quickly. Weakness, tinnitus and heavy sweating are the first sudden signs. The skin becomes pale, blood pressure drops. Loss of consciousness, convulsions and death may occur within minutes. Therefore, it is important to identify the problem in time and begin emergency care.

Stages

There are four stages in the development of shock. The first of these is the cardiogenic variant. This stage is the most common. It is characterized by symptoms of cardiovascular failure. Thus, tachycardia is noted, a person feels a sharp decrease in pressure, a thread-like pulse. There is a disorder external respiration. This variant is not fatal.

• Asthmoid (asphyxial) variant. It is characterized by the manifestation of bronchiolospasm, all of which leads to the development of acute respiratory failure. Choking occurs and is associated with swelling of the larynx.
• Cerebral option. It is characterized by damage to the central nervous system. This happens due to acute edema brain. Hemorrhages, as well as dysfunction of the brain, cannot be ruled out. This condition is characterized by psychomotor impairment. Loss of consciousness and tonic-clonic convulsions often occur.
• Abdominal option. It is characterized by the development of symptoms as a result of taking antibiotics. This may be Bicillin and Streptomycin. Death can occur due to the development of cardiovascular failure, as well as cerebral edema.

Forms

There are several forms of development of pathology. The lightning form is the fastest, this becomes clear from the name itself. It develops within 2 minutes after the allergen enters the body. It is characterized by rapid development of symptoms, as well as cardiac arrest. The signs are very scarce, severe pallor occurs, and symptoms of clinical death appear. Sometimes patients simply do not have time to characterize their condition.

• Severe form. It develops within 5-10 minutes after contact with the allergen occurs. The patient begins to complain of acute lack of air. It is suppressed by a sharp feeling of heat, headache, and develops pain syndrome in the area of ​​the heart. Heart failure develops very quickly. If qualified assistance is not provided on time, death occurs.
• Medium weight form. Development occurs within 30 minutes after the allergen enters the body. Many patients complain of fever and redness of the skin. They are plagued by headaches, fear of death and severe agitation.
• Lightning form characterized by acute onset and rapid progression. Blood pressure drops very quickly, the person loses consciousness and suffers from increasing respiratory failure. A distinctive feature of the form is resistance to intensive antishock therapy. In addition, the development of pathology progresses greatly, possibly leading to a coma. Death can occur for the first time in minutes or hours, as a result of damage to vital organs.

There are options for lightning current. They are completely dependent on clinical syndrome. This may be acute respiratory or vascular failure.

In case of shock, accompanied by acute respiratory failure, a feeling of constriction in the chest develops, the person lacks air, a painful cough, shortness of breath, and headache begin. Available angioedema face and other parts of the body. As the syndrome progresses, death is possible.

An allergic reaction with acute vascular insufficiency is characterized by its sudden onset. The person feels weak, has tinnitus, and pours sweat. The skin becomes pale, blood pressure drops, and the heart is weakened. Death can occur due to an increase in symptoms.

Consequences and complications

As for the consequences, they are influenced by the severity of anaphylactic shock, as well as its duration. The whole danger lies in the fact that the process can negatively affect the entire body as a whole. That is, lead to the failure of many vital organs and systems.

The less time there was between contact with the allergen and the development of shock, the more severe the consequences. For some time, any symptoms are completely absent. But repeated contact can become more dangerous than the first.

Often the problem leads to the development of very dangerous diseases. These include non-infectious jaundice, as well as glomerulonephritis. Severe disruptions occur in the functioning of the vestibular apparatus and central nervous system. The consequences are truly aggravating. Therefore, the faster a person receives emergency care, the higher the chance of preventing death and the development of problems with many organs and systems.

As for complications, they need to be divided into two types. After all, they can occur both after contact with an allergen and during recommended treatment. Thus, complications caused by contact with an allergen include respiratory arrest, disseminated intravascular coagulation syndrome, and bradycardia, which leads to cardiac arrest. Possible development of cerebral ischemia, renal failure, as well as general hypoxia and hypoxemia.

Complications after improper therapy are also aggravating. They can occur in almost 14% of all cases. This may be due to the use of adrenaline. Against this background, tachycardia occurs various types, possible arrhythmia and myocardial ischemia.

During treatment, it is necessary to understand that cardiopulmonary resuscitation may be needed at any time. You should know how this is done. After all, the process must be performed using standard ALS/ACLS algorithms.

Diagnosis of anaphylactic shock

Diagnosis should begin with interviewing the victim. Naturally, this is done in cases where the manifestation of shock does not have a lightning-fast form. It is worth checking with the patient whether he has previously had allergic reactions, what caused them and how they manifested themselves. You should find out information regarding the medications used. These can be glucocarticoids, antihistamines or adrenaline. They are the ones who can lead to the development of a negative process.

After the interview, the patient is examined. The first step is to assess the person's condition. Then the skin is examined, sometimes it becomes bluish or, on the contrary, becomes pale. Next, the skin is assessed for the presence of erythema, swelling, rash or conjunctivitis. The oropharynx is examined. Often anaphylactic shock causes swelling of the tongue and soft palate. The victim's pulse should be measured. Airway patency and the presence of shortness of breath or apnea are assessed. You should definitely measure your blood pressure; if the condition is severe, it cannot be determined at all. In addition, it is necessary to clarify the presence of symptoms such as vomiting, vaginal discharge (bloody type), involuntary urination and/or defecation.

Tests for anaphylactic shock

This process is characterized by a very peculiar manifestation, which may differ depending on the affected organs and systems. It is characterized by a sharp decrease in pressure, a disorder of the central nervous system, and spasm of smooth muscles. This is not the entire list of manifestations.

When diagnosing anaphylactic shock, lab tests are not carried out at all. Because you won’t be able to find out anything from them. True, stopping an acute reaction does not always mean that everything ended well and the process has receded. In 2-3% of cases, manifestations begin after a while. Moreover, these may not be ordinary symptoms, but real complications. Thus, a person is able to “get” nephritis, damage to the nervous system, and allergic myocarditis. The manifestations of immune disorders have many similarities.

Thus, the number of T-lymphocytes decreases significantly, and changes also occur in its activity. The level of T-suppressors decreases. As for immunoglobulins, they increase sharply. The blast transformation reaction of lymphocytes increases sharply. Autoantibodies appear in the body.

Instrumental diagnostics

It should be noted that the diagnosis of the process is clinical. There are no such instrumental methods, which could confirm the existence of this process. After all, everything is visible and so. True, despite this, there are still some research methods that are carried out along with first aid. These include ECG, Pulse Oximetry and Plain X-ray chest, CT and MRI.

So, ECG monitoring is carried out in 3 leads. Recording in 12 leads is indicated only for those patients who have been identified with specific cardiac rhythm disturbances characteristic of ischemia. This procedure should not in any way interfere with emergency care. It is necessary to take into account the fact that any changes in the ECG may be caused by hypoxemia or hypoperfusion. Myocardial diseases caused by the use of adrenaline can provoke such a course.

• Pulse oximetry. If SpO2 values ​​are low, it means the person is experiencing hypoxemia. Typically, in the case of anaphylactic shock, this process precedes cardiac arrest. The process can be observed in two states. Yes, when bronchial asthma or stenosing laryngitis. Therefore, everything must be assessed in its entirety.
• Plain radiography of the chest. It is carried out exclusively after stabilization of a person’s condition and if he has signs of lung pathologies. It is advisable to take pictures immediately. Supporting techniques are CT and MRI. They are carried out exclusively in cases where there is a suspicion of pulmonary embolism.

Differential diagnosis

Laboratory tests are not carried out during the development of the reaction. After all, you need to act quickly; there is no time to take tests and wait for an answer. A person needs emergency help.

Increased levels of certain enzymes in the blood indicate that a person has developed a critical condition. So, usually histamine begins to rise sharply, this happens literally within 10 minutes. True, this determination method is not publicly available. Tryptase. Peak values ​​are observed within an hour and a half after the start of the process itself, and they persist for 5 hours. Patients may experience an increase in both two indicators and one.

To determine the level of these enzymes, it is necessary to draw blood. For this, 5-10 ml of sample is taken. It is worth noting that the collection of tests should go in parallel with the emergency care! Repeated collection is carried out 2 hours after symptoms begin to manifest themselves.

5-hydroxyindoleacetic acid. Serves for laboratory differential diagnosis carcinoid syndrome is measured in 24-hour urine. LgE does not play a special role. Only confirmation of the diagnosis is possible.

Treatment of anaphylactic shock

This stage completely depends on the etiology. The first step is to stop the parenteral administration of drugs; a tourniquet is applied to the injection site (just above it) for 25 minutes. After 10 minutes it can be loosened, but not more than 2 minutes. This is done if the problem was caused by the administration of a drug.

If the problem arose due to an insect bite, you should immediately remove the sting using an injection needle. Removing it manually or using tweezers is not advisable. This can cause the venom to be squeezed out of the sting.

Ice or a heating pad with cold water should be applied to the injection site for about 15 minutes. After that, the injection site is chipped in 5-6 places, thus infiltration occurs. To do this, use 0.5 ml of a 0.1% solution of adrenaline with 5 ml of isotonic sodium chloride solution

Antishock therapy is carried out. The person is provided with airway patency. The patient must be laid down, but at the same time his head should be lowered so that there is no aspiration of vomit. The lower jaw should be extended, if there is removable dentures- eliminate them. Then 0.3-0.5 ml of a 0.1% adrenaline solution is injected intramuscularly into the shoulder or thigh area. Administration through clothing is possible. If necessary, the procedure is repeated for 5-20 minutes, while monitoring the pressure level. Next, access is provided for intravenous administration. A person is injected with a 0.9% sodium chloride solution. For an adult, at least one liter, and for a baby, 20 ml per kilogram of weight.

Antiallergic therapy. Glucocorticoids must be used. Prednisolone is mainly used. It is administered in a dosage of 90-150 mg. For children under one year of age, the dosage is 2-3 mg per kilogram of weight. At the age of 1-14 years – 1-2 mg per kilogram of body weight. Administration is intravenous, jet.

Symptomatic therapy. To increase blood pressure, Dopamine is administered intravenously at a rate of 4-10 mcg/kg/min. If bradycardia begins to develop, then Atropine is administered at a dosage of 0.5 mg subcutaneously. If necessary, the procedure is repeated after 10 minutes. In case of bronchospasm, inhalation of Salbumatol should be administered, preferably 2.5-5 mg. If cyanosis begins to develop, oxygen therapy should be administered. It is also necessary to monitor breathing functions, and always have the skill of quick response. After all, resuscitation measures may be needed at any time.

Prevention

It is almost impossible to predict the development of this condition. After all, a problem can arise at any time and for an inexplicable reason. Therefore, you need to be careful when using drugs that have pronounced antigenic properties. If a person has a reaction to Penicillin, then he should not be prescribed drugs from this category.

Be careful when introducing complementary foods to babies. Especially if the presence of allergies is due to heredity. One product should be administered within 7 days, no faster. If a person develops a persistent reaction to the cold, then he should avoid swimming in water bodies. Children are not allowed long time be in the fresh air in winter (of course, if there is a cold problem). You should not stay in places where there are large concentrations of insects, near an apiary. This will avoid an insect bite and thereby cause a state of shock in the body.

If a person has an allergic reaction to any allergen, it is worth taking special medications so as not to provoke its strong development.

Forecast

It should be noted that the incidence of deaths is 10-30% of the total. In this case, much depends on the severity of the patient’s condition. Fatalities due to drug allergies are caused by gross mistakes when choosing a medication. Incorrect selection of contraception can also contribute to this process.

People who have a persistent allergic reaction to penicillin are especially at risk. Using a syringe with its residue can lead to an unexpected reaction of the body, which carries a real danger. Therefore, you need to use only a sterile syringe. All persons who have direct contact with medicines, having at the same time a risk of developing shock, must change their place of work. If you follow special rules, the prognosis will be favorable.

It is important to understand that no spa conditions will help get rid of possible allergies. You just need to limit contact with the main allergen. If you have a strange reaction to staying in cold water or in general to the cold, you need to limit contact with it. This is the only way to save the situation. Naturally, the favorableness of the prognosis is also influenced by the speed of reaction when it develops acute form shock. It is necessary to provide the person with emergency assistance and call an ambulance. Joint action will help save the life of the victim.