Anaphylactic Shock

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 … Anaphylactic Shock: Therapy

Anaphylactic Shock: Classification

Severity scale for classification of anaphylactic reactions according to Ring and Messmer. Grade Skin Gastrointestinal tract(gastrointestinal tract) Respiratory tract(respiratory organs) Cardiovascular system I Pruritus (itching) Flush (redness occurring in fits and starts). Urticaria (hives) Angioedema (bulging elastic swellings (eg, in the facial area: lip, cheeks, forehead) that appear suddenly and disfigure the appearance). – – … Anaphylactic Shock: Classification

Anaphylactic Shock: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: Assessment of consciousness using the Glasgow Coma Scale (GCS). General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes (central cyanosis? (bluish discoloration of skin and central mucous membranes, e.g., tongue). [Flush (seizure-like redness). Urticaria … Anaphylactic Shock: Examination

Anaphylactic Shock: Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests. Blood gas analysis (ABG) – for circulatory instability/shock; determination of: Venous: pH, BE. (Lactate) [Lactate ↑ = oxygen deficiency due to inhibition of aerobic glycolysis] Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential … Anaphylactic Shock: Test and Diagnosis

Anaphylactic Shock: Drug Therapy

Therapeutic target Stabilization of circulatory conditions Therapy recommendation for anaphylactic shock Removal of the triggering substance (if possible) and placement of an i.v. line (administration of full electrolyte solution, VEL). Severity I and II * (mild to marked general reactions): General therapy: antihistamines (e.g., dimetindene, i.v.); in acute therapy and prophylaxis. In bronchospasmolysis (decongestion of … Anaphylactic Shock: Drug Therapy

Anaphylactic Shock: Diagnostic Tests

Obligatory medical device diagnostics in anaphylactic shock. Continuous monitoring of vital signs: Blood pressure (RR): blood pressure measurement* [most important symptom of IkS – but not obligatory – hypotension (low blood pressure) < 90 mmHG systolic for at least 30 minutes, in conjunction with signs of organ diminished perfusion (organ diminished blood flow): cold extremities, … Anaphylactic Shock: Diagnostic Tests

Anaphylactic Shock: Prevention

Secondary prevention of anaphylaxis Epinephrine auto-injector (AAI; epinephrine prefilled syringe); active ingredient: epinephrine hydrochloride (0.36 mg per 0.3 milliliter) = epinephrine (0.3 mg per 0.3 milliliter), i.m. (intramuscular, i.e., into the muscle; outer thigh; faster onset of action: injection into deltoid muscle/deltamus muscle, strong muscle of the shoulder joint)Epinephrine doses depending on body weight as … Anaphylactic Shock: Prevention

Anaphylactic Shock: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate anaphylaxis: Prodromal signs (precursors) of anaphylaxis: Burning sensation on the palms of the hands, soles of the feet, or genital area. Metallic taste Cephalgia (headache) Anxiety, inner restlessness, disorientation. Rapid onset of symptoms (a few minutes to hours) after allergen contact. Symptoms and complaints of anaphylaxis Skin Gastrointestinal … Anaphylactic Shock: Symptoms, Complaints, Signs

Anaphylactic Shock: Causes

Pathogenesis (development of disease) The allergic reaction to a food allergen, insect venom, or drug is usually an immediate-type reaction (type I allergy; synonyms: type I allergy, type I immune reaction, immediate allergic reaction). The initial contact, which is usually asymptomatic, is called sensitization. T and B lymphocytes recognize the antigen independently of each other. … Anaphylactic Shock: Causes

Anaphylactic Shock: Medical History

Medical history (history of illness) represents an important component in the diagnosis of anaphylaxis/anaphylactic shock* . Family history What is the current health status of your family members? Social anamnesis Current medical history/systemic history (somatic and psychological complaints) [third-party history, if applicable]. Do you have any complaints on the part of the skin and mucosa? … Anaphylactic Shock: Medical History

Anaphylactic Shock: Or something else? Differential Diagnosis

Differential diagnoses of anaphylaxis (modified from [S2k guideline]) Respiratory System (J00-J99) Bronchial asthma (without anaphylaxis) or status asthmaticus (persistent severe symptoms of an asthma attack over a 24-hour period; here: without involvement of other organs) Vocal cord dysfunction (engl. Vocal Cord Dysfunction, VCD) – leading symptom of VCD: Abruptly occurring, dyspnea-inducing laryngeal obstruction (laryngeal constriction … Anaphylactic Shock: Or something else? Differential Diagnosis

Anaphylactic Shock: Complications

The following are the most important diseases or complications that may be contributed to by anaphylaxis: Respiratory system (J00-J99) Bronchospasm – cramping of the muscles surrounding the airways. Rhinitis (inflammation of the nasal mucosa). Skin and subcutaneous (L00-L99) Urticaria (hives; anaphylactic reaction: 15-20 min; IgE-mediated: 6-8 h). Injuries, poisonings, and other sequelae of external causes … Anaphylactic Shock: Complications