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Anaphylactic Shock Medical Overview
Anaphylaxis is a severe and sometimes deadly allergic reaction that can occur from many things, including bee stings and certain foods.
The cause of anaphylaxis is a total body allergic reaction to a specific chemical that is an allergen. It comes after being exposed to a substance that becomes an allergen. The first exposure doesn't usually lead to anaphylaxis but it can occur by the second time a person is exposed to the allergen. The reaction happens swiftly and is a severe reaction, affecting the whole body. It is the result of an excessive amount of histamine in the bloodstream.
Things that can contribute to anaphylaxis include certain drugs, such as morphine and x-ray contrast dye), allergies to food, and insect stings or bites. Pollens and plant allergies can rarely cause anaphylaxis in sensitized individuals.
Symptoms of anaphylaxis usually come on rather quickly. Symptoms can include abdominal cramping or pain, confusion, anxiety, abnormal breathing, shortness of breath, diarrhea, cough, hives, itching, fainting, dizziness, nasal congestion, nausea and vomiting, palpitations, slurred speech, wheezing and redness or blotchiness of the skin.
It is important to diagnose anaphylaxis as soon as possible in order to treat it as quickly as possible. The diagnosis of anaphylaxis includes finding an abnormal heart rhythm, hives, pulmonary edema, low blood pressure, rapid pulse, confusion, swelling of the throat and of the eyes or facial area, wheezing and weakness. A physical examination can show the findings noted above and can diagnose anaphylaxis quickly. You can do allergy testing at some point to diagnose the specific thing that is causing the symptoms.
The treatment of anaphylaxis must happen immediately. This means calling 911 and getting the ambulance with treatment right away. The airway, breathing and circulation must be addressed as in any severe emergency. CPR may need to be performed along with medications like epinephrine and Benadryl given to treat the problem. Scrape the stinger off the person if they were stung by a bee and prevent shock by raising the legs and having the person lie down. Don't give oral medications if the person is having difficulty breathing or swallowing. Both epinephrine and Benadryl can be given through an injection.
Things to avoid are assuming that allergy shots alone will protect you from getting anaphylaxis. Don't put a pillow under the individual's head as this makes breathing worse. Don't give things by mouth if breathing is a problem. Endotracheal tube intubation may need to be performed to breathe for the person. If the airway is narrowed, consider using a tracheostomy tube instead. Corticosteroids can be used to block some symptoms of anaphylaxis but it takes awhile for it to kick in.
The prognosis of anaphylaxis is good if treatment is prompt and all possible measures are used to treat the patient. Patients who have this condition without benefit of medical attention can easily succumb to the disease. An Epi-Pen is a good choice for people with risk of anaphylaxis. The person can give themselves epinephrine as soon as they have symptoms.
Complications of anaphylaxis include blockage of the airways, which can be deadly, cardiac arrest, shock and respiratory arrest or stoppage of breathing.
Prevention of anaphylaxis involves avoiding triggers that might bring on anaphylaxis. You should read ingredient labels if you are allergic to a food. If you have a child who might be allergic to certain foods, introduce them slowly and bring on one food at a time. Wear a medical alert tag to say you are allergic to certain foods or bee stings. Bring along an allergy kit that includes injectable epinephrine and Benadryl in chewable form. Don't share Epi-Pens with anyone else as you don't know how it will react with them.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here