Anaphylactic Shock: Therapy

General measures

• Immediately make an emergency call! (Call number 112)
• Allergen exposure, i.e. stop contact with allergenic substances (allergens) to which the body is exposed!
• Symptom-oriented positioning of the patient:
  • Dyspnea (shortness of breath): elevate upper body (semi-sitting).
  • Circulatory dysregulation (hypovolemia: decrease in circulating blood volume): flat positioning with legs elevated (Trendelenburg positioning).
  • Clouding of consciousness: stable lateral position (to keep the airways free: fall back of the tongue and possible vomiting to prevent).
• Placement of venous access (min 18 G) to treat impending hypovolemia (decrease in circulating blood volume): In case of anaphylaxis:
  • Adults: 5-10 min briskly 500-1,000 ml of fluid (more if necessary).
  • Children: 20 ml/kg bw
• Administration of pure oxygen with high flow rate.
• If serious symptoms exist beyond the level of localized skin symptoms (severity II and above), intramuscular epinephrine should be administered primarily.
• Securing the airway (endotracheal intubation/insertion of a tube (hollow probe) through the mouth or nose between the vocal folds of the larynx into the trachea).

Training

• Emergency training: anaphylaxis training is one of the most important preventive measures after anaphylaxis.