Anaphylactic Shock Definition
An anaphylactic shock (allergic shock) is the most severe form in which an allergic reaction may occur as it may endanger the life of the patient. Anaphylactic shock, also called allergic shock or anaphylaxis, is a type of allergic reaction that can be fatal. Anaphylaxis occurs as the body’s response to an allergen that a substance activates the immune system because the body considers it a threat.
Allergies are not the same for everyone, each person may have allergies to certain substances or not present any allergies. Allergies are common to natural substances such as pollen, hair of some animals or some food. But allergies to materials such as latex can also develop. Allergies to pollen and hair do not usually cause anaphylactic shock, but rather allergies biting of some insects, food or medication may cause anaphylactic shock.
Most allergies affect mucous membranes and skin: Rhinorrhea, asthma and urticaria. But if the allergic reaction is very strong, it is called anaphylactic shock, because the reactions of the body or symptoms of the allergic reaction are more severe, lasting, and may endanger the life of the patient. Anaphylactic shock usually occurs immediately after coming into contact with the allergenic substance.
Anaphylactic shock is triggered by an allergic reaction to a particular allergen and is an exaggerated manifestation of the allergic reaction. There are many and varied allergens that can cause an allergic reaction and anaphylactic shock. Allergy can be triggered by insect venom,food and certain medications. The affected person suffers an exaggerated allergic reaction. Allergic shock is very dangerous and can cause cardiac arrest in a short time.
A few seconds after contact with the allergen, for example, after a wasp sting, anaphylactic shock may already occur. This is identified by the following symptoms:
- Difficulty breathing
- Dry mouth
- Burning or paresthesias on the tongue
- Blistering and inflammation of the eyelids
An anaphylactic shock produces some typical signs: blood vessels dilate, fluid accumulates in the tissues, low blood pressure, the pulse accelerates at first, and then descends and the blood supply to the organs gets worse. Patients finally lose consciousness. Without treatment, an anaphylactic shock may be fatal.
Anaphylactic Shock Causes
Anaphylactic (allergic) shock is caused by typical causes, although it can be caused by any type of allergen. People with type I allergies may develop an anaphylactic shock if they come in contact with the allergen (the substance they react to). The most frequent triggers of an anaphylactic shock are:
- Insect bites
- Contrast injections for radiological exams
Most of the time the patient already knows in advance, that he presents allergy to a drug or to a certain food or compound. It is important to know that the cause of an anaphylactic shock. There are substances that most people do not react to or only do lightly, but the person in question reacts exaggeratedly. For example, if you have allergy to peanuts, a small amount for the allergic person is enough to trigger the anaphylactic shock.
The same is true for contrast allergy: Before undergoing a radiological examination with contrast, tell the doctors who treat you (also the radiologist) if you know that you are allergic. In this way the doctor may choose beforehand for another test or another type of contrast. In case of allergy to penicillin, the same procedure must be followed so that the doctor can use an alternative antibiotic.
How is Anaphylactic Shock Diagnosed?
An anaphylactic shock (allergic shock) leads the patient to an imminently threatened state requiring immediate diagnosis and treatment by a physician. It is imperative to receive health care as soon as possible, and then it must be diagnosed the causes that have triggered anaphylactic shock, if it is the first time it occurs, so that it does not repeat itself.
It is easy to detect because the symptoms are very intense and develop within seconds or minutes. Anaphylactic shock is detected in most cases, because shortly after a fact that can trigger it, such as an insect bite or a contrast injection, typical symptoms appear as the following:
- Skin rashes, blisters (hives)
- Redness of the face or skin of the body
- Circulatory disorders, tachycardia
- Dry mouth, dry tongue
- Difficulty breathing, anxiety
Sometimes chest discomfort or tightness, severe coughing (usually accompanied by breathing noises identified as hooting or squeaking) diarrhea, difficulty swallowing, stuffy nose, or even swelling of the face, eyes, or tongue. In some cases, anaphylactic shock can be very intense and lead to loss of consciousness, especially if you do not act fast enough. This is extremely serious and you should see your doctor immediately.
The physician perceives the typical signs of anaphylactic shock and measures pulse and blood pressure and initiates treatment immediately. Other tests (such as blood tests, ECGs) can be done at the hospital.
Among the tasks necessary to make a good diagnosis of what caused the anaphylactic shock, the doctor should perform a questioning of the patient (anamnesis): what do you think could trigger the reaction, what has eaten or drunk in the last hours , If you have been in contact with any medication, or what risky activities you have been able to do to make this reaction occur.
The purpose of the diagnosis is to ensure that anaphylactic shock does not recur, as it is very dangerous and potentially fatal. The most effective is to determine the allergen and systematically avoid its contact with it.
How is Anaphylactic Shock Treated?
An anaphylactic (allergic) shock is an emergency and requires immediate treatment. First, it is important to immediately stop contact with the allergen (eg, withdraw intravenous contrast administration) if possible. Place the affected person in the shock position (body lying flat with legs raised above the heart) and call the emergency room doctor.
The doctor places an access into the vein through which he / she administers the following medications:
- Adrenaline, which can be administered subcutaneously
- Liquid (plasma expander / HES, Ringer’s solution, saline solution)
- Glucocorticoids (cortisone, prednisolone)
- Antihistamines (clemastine, cimetidine)
In addition, the physician may administer beta-2-sympathomimetics. These substances dilate the bronchi and are useful if anaphylactic shock causes inflammation and constriction of the airways.
After the emergency treatment the patient should be observed, examined and treated in the intensive care unit of a hospital, since the allergic reaction can be repeated.
Some people know that they may have an intense allergic reaction, for example to insect bites, and may cause an anaphylactic shock. In these cases it is convenient to carry an emergency kit. This contains an autoinjector with which the patient can inject adrenaline in case of emergency (just after a wasp sting etc.). In addition to the auto-injector, the emergency kit also contains other medications, such as a glucocorticoid preparation and an antihistamine. This allows the affected person to help himself quickly or to be accompanied by a companion, especially in situations where emergency medical care can not be obtained immediately (for example, in countries where one is on vacation) And it does not know its emergency system. We should inform ourselves well before traveling about how the health system works. If you carry an emergency kit of this type, you should read the instructions carefully and clarify any doubts with your doctor or pharmacist.