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Anaphylactic shock

Autor: doc.dr Goran  Marijanović    


There is no man who, during his life hasn’t had any allergic difficulties; yet, in most of the cases, they were mild and short term. However, a small number of persons, who are very prone to allergies, have experienced a life danger reaction, known as anaphylaxis. Anaphylaxis is a quite rare phenomenon, and it is mostly present in people who have asthma, eczema, hay fever, etc.

What are the symptoms?

The symptoms begin all of a sudden, a few seconds or minutes after being exposed to allergen (substance which causes allergic reaction). It sometimes appears 2 or 4 hours, or rarely 12 hours after being exposed to the substance that causes it. The patient feels swelling up, itching or has a rush all over the skin. Some people have difficulties in breathing, they choke and become insecure.  Sometimes, there is a fear of near death. Some people have spasms in the stomach, sickness or diarrhea. Some people even lose consciousness.

What causes anaphylaxis?

There are many causes of this reaction. The most usual causes are:
  • Drugs, especially antibiotics-penicillin, aspirin and many analgesics, as well as contrasting means used in radiology.
  • Food, especially sea fruits (shells), peanuts, walnuts, eggs and fruit.
  • Bite of an insect, especially wasps, bees and hornets.
  • Latex, which can be found in surgical gloves or gloves used in housework.

When is the risk of anaphylaxis greatest?

Everyone who has once survived an anaphylactic shock is a potential candidate for the repetition of this reaction. Persons, allergic to food (especially shells, peanuts and walnuts) and asthmatics have a higher risk of anaphylaxis. These persons are especially endangered because they do not have everyday need to take anti-allergic drugs and they often don’t recognize the earliest symptoms.

What are the characteristics of anaphylactic reaction?

Allergic reaction begins at the place of the contact of the body with the allergen that causes the reaction. That is how the food, which can be allergen, causes tingle, itching and metal taste in the mouth, as well as the swollen mouth, tongue and throat. With the bite of an insect, there is an itch and swelling up around the bite. Generalized reaction can be developed as a rash and redness all over the body. The face and soft tissues swell up, whereas breathing becomes difficult. The person becomes upset; the sounds it hears become metal and there’s a feeling of sinking. The blood pressure is low. At that moment, the person collapses and loses consciousness. These symptoms begin 5-15 minutes after the contact with allergen, but they can also begin after 2 hours. The progress of difficulties can develop for hours. After a mild initial reaction, some persons feel spontaneous improvement, but after 3-4 hours, difficulties begin again. This is called a two-stage reaction.

How to prevent anaphylactic reaction?

If you have ever had this kind of reaction or allergy, you should mention it to your doctor or dentist. If you know what you are allergic to, this can be very useful information. You should avoid eating food which causes allergy. Even small amounts of these substances can cause problems. Always read the contents on the packet of the food you buy. Consult your doctor about the risks related to substances which are similar to the one that causes allergy. Make sure your family members and friends know what you are allergic to and where you keep your drugs, so that they could know how to react at that moment. Don’t forget to carry with you a drug that is necessary in such situations. You should consult your doctor about adequate drugs you should use.

What to do in case of a reaction?

Anaphylaxis has to be immediately treated because respiratory difficulties and shock spread very quickly. If a person feels consciousness disorder, instability, low blood pressure, what you can do in a restaurant, in the street or elsewhere outside the hospital, is to place the patient into a laying position, raise his low limbs above the level of the head in order to improve the return of the blood into the heart. This will stop the dropping of blood pressure for a moment. The patient’s head should be turned into the right or left side; then, you should call 911, pointing out you think the patient maybe has signs of anaphylaxis. If the patient has lost his consciousness, you should check if his mouth and nose are passing, and if not, take out braces, artificial jaws, retained food, etc. After that, you should place the patient into a lateral position. Persons who are conscious and have a strong feeling of choking represent an exception. They should be placed into a sitting position. In most of the cases, further treatment can be carried out only by a team of professionals, which gives adrenaline, injects the needle into the vein, and transports the patient to the hospital.

Goran Marijanovic, MD, TA

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