A hormonal drug used for anaphylactic shock. Treatment of anaphylactic shock

Anaphylactic shock- an acute allergic reaction that can be fatal. It affects various systems organs, but are most often subject to impact

respiratory system

the cardiovascular system

skin and mucous membranes

gastrointestinal tract

In this case, the speed of processes characteristic of normal processes accelerates tens of times, and their manifestations are much more pronounced.

Causes of anaphylactic shock

Determining the cause of anaphylaxis is often too difficult big amount allergens that can act as a catalyst. Based on statistics, we can say that in most cases the body reacts in a similar way to

bites of various insects

food products

taking certain types of medications

interaction with contrast agents.

Insect bites. There are over a million insects of different species in the world, the bite of which can provoke an anaphylactic reaction. But most often, allergies occur in victims of bees or wasps, and in 1% of those stung, it can develop into anaphylaxis.

Food triggers anaphylaxis in at least a third of susceptible people. food allergies. Among the most dangerous products include

Nuts: primarily peanuts and their derivatives (oil, etc.), hazelnuts, walnuts and Brazilian nut

• Seafood: fish, shellfish, crab meat

Less common is an acute allergic reaction to eggs and fruits or berries (bananas, grapes, strawberries).

Medications lead to anaphylactic reactions in a significant number of cases. Among the medications that can lead to this result:

antibiotics (especially penicillin, ampicillin, bicillin and others penicillin series)

anesthetics used during surgical operations: intravenous - Propofol, Thiopental and Ketamine and inhalation forms - Sevovluran, Halothane, etc.)

non-steroidal anti-inflammatory drugs, including the common ones aspirin and paracetamol

angiotensin-converting enzyme inhibitors (Enalopril, Captopril, etc.), used for

The latter type of drugs (ACE inhibitors) can cause an allergic reaction leading to anaphylactic shock, even if the patient has been taking the drug for several years.

Other groups of medications lead to the onset of anaphylaxis within a few minutes or hours after the first dose.

However, the risk of allergic reactions to the use of these drugs is very small. It is difficult to compare it with the meaning of positive therapeutic effect from these medications. The likelihood that the body will perceive them as an allergen and produce an anaphylactic reaction is

1 in 5,000 when taking penicillin

1 in 10,000 when using anesthetics

1 in 1,500 when using non-steroidal anti-inflammatory drugs

1 in 3,000 with angiotensin-converting enzyme inhibitors

Contrast agents used in diagnostics various diseases. Most often they are administered intravenously during radiological examinations. internal organs: fluoroscopy, computed tomography or angiography. They help to examine in detail the organs in which pathology is suspected. The danger of anaphylaxis in this case is about 1 case per 10,000 studies.

Symptoms of anaphylactic shock severity

Depending on the route of entry of the allergen into the body, the time after which the first symptoms appear varies. Thus, an insect bite promotes an almost instant reaction, developing from 1-2 minutes to half an hour. Food allergies reveal themselves over a longer period of time - from 10 minutes to several hours.

As a rule, the development of symptoms occurs within 5-30 minutes from the moment of onset. Depending on the severity of the process, there may be either a minor skin reaction or an acute reaction that affects all body systems and leads to death. The faster the intensification of the symptoms that appear, the higher the likelihood fatal outcome if help is not provided on time.

The most clearly expressed are the following clinical symptoms that show involvement in the process various organs and systems:

Skin changes characterized by a bright rash with severe itching

Changes in mucous membranes causing watery eyes and eyes, lips, tongue and nasal passages

Breathing disorders due to involvement of the respiratory tract, swelling and spasms

Swelling of the throat leads to a feeling of a lump, squeezing of the neck

There are three degrees of severity of anaphylactic shock, each of which is characterized by certain symptoms. All of them are described in detail in the table.

Currently medical research do not have the ability to predict in advance the possibility of an anaphylactic reaction if it has never occurred before. The risk group includes anyone suffering from allergies. The diagnosis itself is made later: either during the reaction itself based on the symptoms and the speed of their development, or after relief. Due to the enormous danger of delay leading to death, it is not possible to study each of them in detail. characteristic features anaphylaxis. The speed with which health deteriorates requires prompt treatment.

Detection of the allergen that provoked such a reaction in the body is an important step following the treatment of anaphylaxis. If you have not encountered allergies before, then all the necessary specific studies should be carried out for you, which clarify the diagnosis of allergies in general and the cause of an anaphylactic reaction in particular:

Skin tests

Skin or patch tests (Patch test)

Blood collection for IgE testing

Provocative tests

The purpose of laboratory tests is to accurately identify the allergen that leads to a given reaction. To ensure safety in case of an excessively strong response from the body, the study should be carried out as carefully as possible.

RAST (radioallergen sorbent test) considered the most safe research. This radioimmunological method allows you to most accurately determine the culprit of anaphylaxis without interfering with the activity of the patient’s body. To carry it out, the interaction of the victim’s blood with allergens successively added to it is analyzed. The release of a significant amount of antibodies after the next injection indicates the detection of the allergen that caused the reaction.

The speed of development and severity of symptoms accompanying anaphylaxis classifies it as an emergency condition requiring immediate medical intervention. The terminal phase of this condition is called anaphylactic shock.

Every second counts when anaphylaxis is suspected. Whether you or someone around you has symptoms, the first thing you should do is call an ambulance. Proper assistance before doctors arrive increases the chances of survival.

It is necessary to immediately eliminate contact with the allergen. If it enters the body through the esophagus, and the victim is conscious, gastric lavage is performed. If after an insect bite there is a sting left in the body, it is removed. You can apply a tourniquet above the bite or injection site medicinal product to slow down its penetration into the body.

Anaphylactic shock is almost guaranteed to occur when the allergen re-enters the body. Therefore, if you suspect anaphylaxis, you should always keep a kit with you. emergency assistance, including adrenaline injectors.

These include:

They are administered intramuscularly through any route of allergen penetration. Usually the injection is given in the back lateral surface thigh muscles, avoiding getting into adipose tissue. Reading the instructions will tell you how to administer the drug correctly. Most often, after administration, the injector is fixed for several seconds in the position in which the drug was injected. After a few minutes the condition should improve, otherwise repeating the dose is permissible.

If the victim has lost consciousness, it is necessary to give the body horizontal position, laying his head to the side. Removable dentures are removed from the mouth. The safety of vomit release and the possibility of tongue retraction are monitored.

If there is no pulse, it is performed artificial respiration and indirect cardiac massage - if you have the skill to correctly carry out these resuscitation measures.

After first aid is provided by visiting doctors, the hospital treatment. For this purpose, the same medications are used as in the treatment of allergies. After 2-3 days, at the latest after 10 days, the patient is discharged.

In order to save your life, you need to remember the importance of preventing anaphylaxis. Avoid substances containing allergens, places possible appearance insects or plant growth that causes allergic reactions. You should always have a set of adrenaline injectors and an allergy passport with you.

It will not be difficult for a doctor to diagnose anaphylactic shock in a patient, since the symptoms of this condition most often do not raise doubts. Knowing the rules for providing first aid to a victim, you can high degree chances of helping save his life.

So, if it has been noticed that a person is developing anaphylaxis, then it is necessary to first call an ambulance. The victim himself should be laid on a flat and hard surface, his head turned to one side, and his limbs raised. If a person has an episode of vomiting, he will not choke on it. Access must be provided fresh air by opening the windows in the room.

Then you need to make sure whether the person is breathing or not. If the movements chest are missing, then you need to bring a mirror to his mouth. When there is breathing, the mirror will fog up. When this does not happen, you need to start implementing artificial respiration techniques.

You also need to feel your pulse. It is best identified at the wrist, carotid and femoral arteries. If there is no pulse, then a artificial massage hearts.

It is imperative to stop the influence of the allergenic factor on the human body. If anaphylactic shock develops as a result of a bee sting, then it is necessary to remove the sting and apply a bandage-tourniquet to the site of the bite. This will allow the poison to not spread through the bloodstream so quickly. You should also apply ice to the bite site.

Emergency doctors who have diagnosed anaphylactic shock will administer adrenaline to the victim. This is an anti-allergenic remedy with an immediate effect. Adrenaline is injected into the bite site and also injected into a limb that is not affected by the allergen. If a person’s breathing is severely impaired, then the injection is placed at the root of the tongue. The drug is administered slowly and carefully so as not to provoke arrhythmia.

It is possible to relieve swelling of the larynx with an injection of adrenaline. If this does not help, then intubation, conicotomy or tracheostomy is required. All of these procedures involve opening the airways to provide oxygen to the lungs.

The work of doctors does not stop there. The patient is indicated for the administration of corticosteroids and antihypertensives. Drugs such as Suprastin and Diphenhydramine remain a priority, since they do not lower blood pressure and themselves are not capable of triggering an allergic reaction. Oxygen inhalation is also performed.

If the allergen cannot be identified, then the hospital performs a number of techniques aimed at identifying it.

To do this, the following studies are carried out:

Patch test (application test).

Blood sampling to determine immunoglobulin E.

Provocative tests.

Skin tests.

These studies will allow you to isolate the allergen and select the optimal treatment.

Despite the fact that the person was provided with timely assistance, anaphylactic shock rarely goes away without leaving a trace on health. Certain disturbances occur in the body that make themselves felt over a long period of time.

The most common consequences of anaphylactic shock include:

To relieve these consequences, it is necessary drug therapy, but the doctor must prescribe it. In this case, the specialist must be informed that the person has suffered anaphylaxis.




As for the prevention of anaphylactic shock, there are simply no specific recommendations. However, there are points that you should pay attention to.

Those people who suffer from allergies on an ongoing basis are more susceptible to anaphylactic shock. Therefore, they need to exercise extreme caution when coming into contact with any potential allergens.

At risk include asthmatics, patients with eczema, mastocytosis and allergies. In such people, anaphylactic shock can develop even when eating certain foods or when taking a number of medications. This is not a reason to refuse any treatment. It is necessary to follow medical recommendations in mandatory, but the doctor must be informed that the person is at risk for developing anaphylactic shock. Also, anaphylaxis in such patients may develop in response to administration contrast agent to perform a radiological examination.

Concerning medical specialists, then they must know and clearly follow all instructions for eliminating anaphylactic shock in patients. Medical institutions and ambulances must be provided with anti-shock drugs and emergency aid devices.

You should definitely have an adrenaline injector at home. This is a one-time injection of adrenaline, it is completely ready for use. Sometimes such a small ampoule can save a person’s life. For example, in Western countries adrenaline can be found in almost every home medicine cabinet.

To an ordinary person It is recommended to acquire knowledge regarding first aid for anaphylactic shock. First of all, this concerns the technique of execution indirect massage heart and artificial respiration. No less important in any situation, even in emergency situation, keep a cool head and don’t panic.




Education: Moscow medical school them. I. M. Sechenov, specialty - "General Medicine" in 1991, in 1993 " Occupational diseases", in 1996 "Therapy".

As medical statistics show from various kinds allergic diseases Now almost every third person suffers. This prevalence of such ailments is explained primarily by lifestyle modern people. One of the most dangerous forms of allergic reactions is considered to be anaphylactic shock, which when absent adequate treatment and first aid can be fatal. Therapy this state carried out exclusively in the inpatient department; after the first symptoms you must immediately call ambulance. How is anaphylactic shock treated, and what drugs are used?

Do-it-yourself first aid

At the first suspicion of anaphylactic shock, it is necessary to call an ambulance, which will have to hospitalize the patient. In addition, you should protect the victim from the source of the allergen - eliminate the insect sting or stop using medicine etc. The patient must be placed on his back and his legs raised slightly; it is also important to check whether he has consciousness and the ability to respond to simple questions and the ability to respond to mechanical irritations.
First aid for anaphylactic shock includes a number of standard measures - clearing the airways, performing cardiopulmonary resuscitation if necessary.

First aid

At the first manifestations of anaphylaxis, medications can be used to eliminate/relieve symptoms; such drugs can truly save lives. Medicines used for anaphylactic shock include adrenaline, some hormones and antihistamines.

Adrenaline can be purchased in the form of ampoules and a special device - a syringe pen. The drug is administered intramuscularly, including through clothing. A person can use it independently by entering into middle part thighs or deltoid muscle. In adults, it is customary to use 0.3-0.5 ml of solution (0.1%), and children are administered from 0.1 to 0.3 ml of this substance.
If the drug does not give the expected effect, it can be re-administered at intervals of five to ten to fifteen minutes, focusing on the patient’s well-being.

The use of adrenaline helps to increase blood pressure by constricting blood vessels in the periphery, increase cardiac output, and eliminate spasms in the bronchi. In addition, this medication suppresses the active release of histamine quite well.

Hormones such as hydrocortisone, dexamethasone or prednisolone can also be used to correct anaphylactic shock. When providing first aid, they can be administered intramuscularly or intravenously. So adults are usually administered 0.1-1g of hydrocortisone, 4-32mg of dexamethasone and up to 150mg of prednisolone. Such funds in short terms stop the release of elements, causing allergies, eliminate inflammatory processes, swelling and bronchospasm.

Also, eliminating anaphylactic shock by initial stage its development can be carried out through intramuscular injection antihistamine compounds, which quickly improve the patient’s condition. So, adults can be administered 1 ml of a 0.1% solution of Tavegil or Diphenhydramine and 2 ml of a 2% solution of Suprastin.

Also, correction of anaphylactic shock may involve the use of a combination of antihistamines that block H1 and H2 receptors. Quite often, doctors combine diphenhydramine with ranitidine, again administering them intravenously.

Eufillin and Albuterol can be used to restore airway patency. They are usually administered intravenously, but if this is not possible, doctors recommend using Salbutamol in aerosol form for inhalation use. When administered intravenously, Eufillin is used in a dose of five to ten milliliters in a 2.4% solution, and Albuterol is used in a dose of 0.25 mg for two to five minutes. If necessary, such agents can be reapplied at intervals of a quarter of an hour to thirty minutes. These drugs are quite effective in expanding Airways- bronchi and bronchioles.

Therapy in the intensive care unit

In addition to the drugs already listed, doctors also take measures to detoxify the body and fully replenish the volume of circulating blood. For this purpose, it is customary to use isotonic NaCl solution, as well as solutions of polyglucin or reopoluglucin. Administration of anticonvulsants may be required.

Doctors also provide life support important functions body, and if necessary, carry out resuscitation actions. To maintain the pressure and pumping activity of the heart, Dopamine is used in an amount of 400 mg, dissolved in 500 ml of a five percent dextrose solution. In some cases, if necessary, the patient is transferred to a ventilator.

Every patient who has suffered anaphylactic shock should remain under the supervision of a doctor for two to three weeks, as this pathological condition often leads to the development various complications in the activity of the heart and blood vessels, as well as the urinary system. Blood and urine tests, as well as an ECG, are mandatory.

Treatment of anaphylactic shock should be carried out only under the supervision of a doctor; drugs and their dosage are selected by the doctor on an individual basis.

Clinical picture of anaphylactic shock, regardless of etiological factor(medicinal, food, cold, insect bites), characterized by a sudden onset. Immediately after a specific allergen enters the body of a sensitized person, severe weakness, nausea, chest pain, and fear of death occur. Within a few seconds or minutes, these phenomena increase, and the patient loses consciousness, without even having time to complain about his condition. Such a lightning-fast course of anaphylactic shock often ends in death. Clinically expressed are severe pallor of the skin, cold sticky sweat, the pulse becomes threadlike, blood pressure drops sharply, suffocation and clonic convulsions occur. Symptoms of shock may appear at the time of administration of the allergen drug. In some cases, manifestations of shock increase more slowly, first appearing a feeling of heat, redness of the skin, tinnitus, itching of the eyes, nose, sneezing, dry painful cough, noisy breathing, cramping pain in the abdomen.

A. S. Lopatin (1983) gives 5 variants of the course of anaphylactic shock: typical form, hemodynamic variant, asphyxial, cerebral and abdominal. The author notes that the so-called typical form of anaphylactic shock is characterized by: arterial hypotension, disturbance of consciousness, respiratory failure, skin vegetative-vascular reactions and convulsive symptoms. Other options are variations of the main form depending on the leading symptom and require appropriate treatment.

In the hemodynamic variant of the course of anaphylactic shock, the symptoms of the disorder come to the fore in the clinical picture cardiovascular activity: severe pain in the heart area, rhythm disturbance, weak pulse, drop in blood pressure, muffled heart sounds.

Peripheral vessels may be spasmed (pallor of the skin) or dilated (hyperemia, edema). Other clinical symptoms of shock are less pronounced.

In this variant of anaphylactic shock, the administration of vascular and cardiotonic drugs is of primary importance.

Since the leading symptom of this type of shock is acute cardiovascular failure, sometimes it is misinterpreted, especially if the patient has a history of diseases of the cardiovascular system.

In the asphyxial variant, the leading place is occupied by acute respiratory failure associated with laryngeal edema, bronchospasm, edema of the mucous membrane of the bronchioles or pulmonary edema.

The severity of the condition in such shock is associated with the degree of respiratory failure.

This type of shock is more common in children, especially with food allergies, when when an allergen enters the mouth, swelling of the pharynx and apnea quickly occur. And since the symptoms of suffocation develop very quickly, there is an assumption of aspiration foreign body, which leads to the wrong tactics of the doctor.

In children infancy cases of shock have been described when introduced into the diet cow's milk, especially if during previous appointments there were rashes, diarrhea, vomiting, which were not paid attention to. Pediatricians believe that some cases sudden death infants may be associated with anaphylactic shock due to intolerance to cow's milk.

The cerebral variant of anaphylactic shock is rarely observed in isolation. Characteristic violations observed from the central nervous system: agitation, loss of consciousness, convulsions, respiratory rhythm disturbances, sometimes acute swelling and edema of the brain, status epilepticus with respiratory and cardiac arrest.

With the abdominal version of shock, symptoms come to the fore acute abdomen- pain in the epigastric region and throughout the abdomen, vomiting, urge to stool, which often leads to diagnostic errors. Often patients with the abdominal form of anaphylactic shock end up on the operating table.

Thus, the clinical symptoms of anaphylactic shock are varied and consist of a combination of syndromes from various organs and systems of the body. The type of allergen, the route of entry into the body and the dose do not affect clinical picture and severity of anaphylactic shock.

In almost every individual case, anaphylactic shock occurs with certain distinctive features. There are severe and moderate forms of anaphylactic shock. Since shock usually occurs soon after the allergen enters the body, there is no prodromal period, although in different cases there is a preliminary appearance of anxiety, fear, general weakness, sharp headache. A skin rash, itchy eyes, nose, and general itching may appear. More often, shock occurs instantly and is characterized by collapse, loss of consciousness, respiratory failure, drop in blood pressure, pain in the abdomen and joints. Convulsions may develop and foam may appear at the mouth. Death, if assistance is not provided in a timely manner, can occur within 5-30 minutes or after 24-72 hours as a result of damage to the kidneys, heart, liver and other vital organs.

Often, anaphylactic shock occurs in two phases, when, after some improvement in the condition, a sharp drop in blood pressure occurs again, and if help is not provided, the patient may die.

Possible in case of anaphylactic shock late complications, therefore, all patients who have suffered shock should be observed by a doctor for 12-15 days.

Anaphylactic shock or anaphylaxis – severe course an allergic reaction to taking medication, eating food, an animal bite, or ingesting dust or plant pollen. Normally, these substances should not cause any negative reactions, but in pathology an acute immune reaction develops, which is called an allergic reaction.

In fact, any manifestation of allergies, including anaphylactic shock, is an incorrect perception by the immune system of potentially allergenic substances: drugs, food, dust, pollen, animal excretions. Even bites from insects, snakes and spiders should be tolerated normally by the body (pain at the site of the bite does not count). But increasingly, the immune system malfunctions and an allergic reaction develops in response to irritants.

How dangerous is anaphylactic shock?

Anaphylactic shock is characterized by a release into the blood after an allergen enters it huge amount such active substances, which lead to serious disruptions in the body. If the production of these substances is not stopped, the consequences are often disastrous, including disability and even death.

Under the influence of active substances (serotonin, histamine, bradykinin), swelling of internal organs, mucous membranes and skin; pressure increases and decreases abruptly; violated heartbeat; breathing is impaired and oxygen starvation occurs; the permeability of the walls of blood vessels increases with the risk of their rupture and hemorrhage. A number of other unfavorable changes also occur. If the situation is not resolved, then serious consequences will occur in the form of cerebral edema, hemorrhages in the internal organs and brain, acute and deadly oxygen starvation, renal, cardiac or respiratory failure will develop, and spasms in the lungs or bronchi will begin. In addition, the patient has a strong itchy skin, he experiences headaches, heart or abdominal pain, his body swells. Against this background, the patient is tormented by anxiety, he feels fear, his consciousness is confused, and the functions of breathing and swallowing are impaired. It goes without saying that such a serious condition requires immediate intervention and providing assistance.

How to help a person with anaphylactic shock?

First of all, you need to call an ambulance. It is the team that will have those drugs that are not freely available in pharmacies, necessary to eliminate spasms of the lungs and bronchi, and restore breathing.

If the state of shock is caused by an insect bite or the introduction of an allergen drug, then you need to apply a tourniquet above the site of the allergen, write down the time the bandage was applied and indicate what caused the development of anaphylactic shock.

After this, you need to open the window to allow fresh air to enter, lay the victim on his side and tilt his head. It is necessary to monitor his condition, and if convulsions begin, control the position of his tongue so that it does not sink in and interfere with the flow of air.

After this, it is necessary to administer drugs intramuscularly or subcutaneously to the patient to alleviate the condition. The main drugs for anaphylactic shock are adrenaline or epinephren and prednisolone. Prednisolone can be replaced with dexamethasone. Both are steroidal (hormonal) anti-inflammatory drugs.

Adrenaline is necessary in order to normalize the functioning of the heart in order to avoid heart failure, relieve vascular spasm, eliminate convulsive syndrome, lower intraocular pressure, which can disrupt the structure of the retina and lead to irreversible changes fundus. Prednisolone relieves swelling, including eliminating swelling of the mucous membranes of internal organs, narrowing blood vessels and restores their normal permeability, suppresses the production of biologically active substances, temporarily suppresses the work immune system. Prednisolone has no contraindications for anaphylactic shock, but it should be administered with caution to patients with tuberculosis, hepatitis, herpetic diseases, as well as people with immunodeficiency.

Adrenaline is injected subcutaneously - into the shoulder or thigh; people of full build can be injected under the shoulder blade. The game is inserted at 15 mm, the insertion angle is 45 degrees. Prednisolone and other drugs are administered intramuscularly - into the external upper lobe buttocks or thigh, inserting the needle a third of the length at an angle of 90 degrees.

The next step is introduction antihistamines, familiar to the patient. If he can't swallow, then he has to choose not to. oral medications, and solutions for injections. Injections of anti-allergenic drugs should be done according to the instructions, but if it states intravenous administration, then you need to inject either under the skin or intramuscularly. Intravenous injections can be done professionally and safely by people who have undergone special training medical training. If suprastin is chosen as an antihistamine, it should not be mixed in the ampoule with other drugs.

What medications should you have in case of anaphylactic shock?

Packing a first aid kit to help an allergy sufferer is a serious matter and requires a careful approach. The list of drugs to help with anaphylactic shock is as follows: adrenaline; prednisolone (hydrocortisone, dexamethasone or other anti-inflammatory steroid - adrenal hormone); an antihistamine such as Tavegil, Cetrin, Suprastin or another, which is recommended by an allergist; absorbent for removing toxins during oral administration of an allergen drug, for example, Polysorb, Enterosgel, Enterol; Activated carbon. It is advisable to also add a drug - a substitute for digestive enzymes - mezim, festal. These remedies will help restore normal work stomach after recovery from anaphylactic shock.

The first aid kit of someone who has previously suffered anaphylactic shock is formed from antihistamines, indicated for continuous or course use during periods of exacerbation of allergies.

What medications should you take with you on a trip if you have a history of anaphylactic shock?

A traveler's anti-shock kit should include a large number of sterile wipes, syringes, rubber gloves, antiseptic for treating the injection site, cotton wool, bandage, rubber tourniquet, elastic bandage– for soft fixation of the limb if necessary.

Anaphylactic shock is a rapidly developing allergic reaction that is life-threatening. Can develop in just a few minutes. Survival depends on the tactics of the responding personnel. The article discusses questions about what anaphylactic shock is, its symptoms and treatment, the main symptoms and causes of its occurrence.

Why does anaphylactic shock develop?

Anaphylaxis can develop in humans under the influence of such allergens.

1. An extensive group of medications. These include some antibacterial agents for the treatment of infectious pathologies, hormonal drugs, serums and vaccines, some enzymes, NSAIDs, drugs used in dentistry. In some cases, the cause of anaphylactic shock can be blood substitutes, as well as latex.
2. Insect bites. The most dangerous to humans are wasps, hornets, ants and some types of mosquitoes. For some people, flies, bedbugs, lice, and fleas pose a danger.
3. Worms - roundworms, whipworms, pinworms, etc.
4. Animal fur, as well as bird feathers.
5. Herbs. Ambrosia, nettle, and wormwood are especially dangerous for humans.
6. Flowers.
7. Trees, especially those that bloom in early spring.
8. The etiology of shock includes some foods - citrus fruits, berries, protein products, vegetables. For many people, artificial additives - dyes, emulsifiers, fragrances and sweeteners - pose a danger.

Pathogenesis

In pathogenesis there are three rapidly changing stages - immune, pathochemical and pathophysiological. First, the allergen comes into contact with cells that secrete specific proteins - globulins. They cause the synthesis of highly active substances - histamine, heparin, prostaglandins, etc.

As shock develops, these substances penetrate into tissues and organs human body, cause painful process, which can lead to the development of edema, severe breathing problems and cardiac activity. In cases rapid development If an allergic reaction is left untreated, death occurs.

Stages and variants of the course

The classification of types of anaphylactic shock is as follows.

1. Swift. It is malignant because it causes severe insufficiency heart and lungs. Moreover, it is developing extremely quickly. The probability of death in the fulminant course of such a pathology is about 90%.
2. A prolonged version of shock occurs when certain drugs are administered.
3. The recurrent version of shock is characterized by the fact that its episodes can be repeated many times. This happens if the allergen continues to enter the body.
4. Most mild form the disease is abortive. This condition can be easily treated without consequences for the person.

There are three stages of anaphylactic shock.

1. Prodromal period. The first signs of the development of pathology include weakness, nausea, dizziness, and blisters appear on the patient’s skin. Sometimes, at the warning stage, anxiety, a feeling of suffocation, and discomfort appear.
2. At its height, the patient loses consciousness, his skin is pale. The blood pressure drops and signs of hypovolemic shock are observed. Breathing is noisy, cold sweat appears on the skin, lips are cyanotic.
3. During recovery, weakness and severe dizziness are observed for several days. There is often no appetite.

There are three degrees of severity of the disease.

1. With a mild course of the disease, the prodromal period lasts up to a quarter of an hour, blood pressure drops to 90/60 mm, fainting is always short-lived. The shock is well controlled.
2. With moderate severity of anaphylactic shock, the pressure drops to 60/40 mm, the warning stage lasts minutes, and the duration of loss of consciousness is about 10 - 15, sometimes 20 minutes (maximum time). The effect of the therapy is long-lasting, the patient needs careful monitoring.
3. In severe allergic shock, the prodromal period lasts seconds, blood pressure cannot be determined, and the period of fainting lasts more than half an hour. There is no effect from the therapy.

Signs of shock

Symptoms of anaphylactic shock vary depending on its severity.

Mild degree

At the warning stage, the patient complains of itchy skin and a feeling of heat. Swelling of the larynx progresses, causing breathing problems, and the voice changes and becomes weak. Quincke symptoms appear.

Symptoms of the height of the disease in adults are as follows.

1. Headache, syncope, weakness, blurred vision.
2. Numbness of the tongue and fingers.
3. Painful sensations in the lower back.
4. Pale or blue discoloration of the skin.
5. Wheezing due to developing bronchospasm.
6. Diarrhea, vomiting.
7. Uncontrolled bowel movements and urination.
8. Decreased blood pressure and sometimes the pulse cannot be felt.
9. Increased heart rate.
10. Loss of consciousness.

Moderate shock

At the precursor stage, a person manages to make the following complaints:

• weakness, syncope;
• severe anxiety;
• suffocation;
• Quincke's type edema;
• dilated pupils;
• blue lips;
• involuntary release of urine and feces;
• cold sweat;
• convulsions.

After this, loss of consciousness occurs. Signs of anaphylactic shock are more pronounced: the pressure is low, sometimes it cannot be determined, the pulse is thread-like (often not determined). In rare cases, bleeding from the nose and gastrointestinal tract is observed.

Severe symptoms

Loss of consciousness occurs instantly. The patient does not have time to complain about the symptoms of the pathology.

Attention! First aid (First Aid) must be provided immediately, otherwise death may occur.

In addition to the lack of consciousness, foaming at the mouth and bluish skin are observed. A large amount of sweat can be seen on the forehead. The pupils are dilated, pronounced convulsions are observed. Blood pressure and pulse cannot be determined, heart sound cannot be auscultated.

There are several clinical options progression to a severe stage.

1. Asphyxial. There are signs of breathing disorders and bronchospasm. Due to swelling of the larynx, breathing may cease.
2. Abdominal. The first place is pain in the abdominal region, reminiscent of an attack of appendicitis. Vomiting and diarrhea are observed.
3. The cerebral form is dangerous due to the risk of swelling of the brain and its membranes.
4. The hemodynamic form is characterized sharp drop blood pressure and the development of heart attack-like symptoms.
5. The generalized form is the most common, with all the symptoms described above observed.

Anaphylactic shock in children refers to critical conditions. It is necessary to begin urgent measures to save the baby as early as possible, regardless of the severity of the pathology.

Diagnostics

Important! Diagnosis of this dangerous disease should be carried out as quickly as possible. The patient’s life depends on this, as well as on the experience of the doctor and the tactics of the nurse. Taking anamnesis is very important because anaphylactic reactions may be confused with other pathologies.

There are such diagnostic criteria anaphylactic shock:

• anemia, increase in the number of leukocytes, eosinophilia;
• increased activity of liver enzymes;
• pulmonary edema on x-ray;
• determination of antibodies in the blood.

Emergency help

Especially important! First aid for anaphylactic shock should be carried out as quickly as possible, accurately, smoothly and without panic.

There are such components of the rendering algorithm emergency care with anaphylactic shock.

1. Lay the victim on a hard surface, raising his lower limbs.
2. Turn your head to prevent vomit from entering your lungs.
3. Open the window.
4. Apply an ice pack to the area of ​​the insect bite.
5. Determine the presence of a pulse: if it cannot be heard, then start artificial ventilation lungs and indoor massage hearts.
6. Call an ambulance or transport the victim to a clinic.

During pregnancy, an ambulance should be called urgently, even if the patient easy stage diseases. All emergency measures are carried out only by a doctor.

Compliance with such an algorithm of actions when first aid- guarantee of a favorable outcome of a severe allergic condition. The components of first aid in such emergency cases should be known to everyone.

Medical treatment for anaphylactic shock

Treatment of anaphylactic shock in the emergency room consists of the following measures.

1. Monitoring of basic functions - measurement of blood pressure, heart rate, electrocardiography.
2. Cleaning the oral cavity from vomit, if necessary, intubation of the trachea, incision of the larynx to normalize the flow of oxygen. Tracheotomy is performed exclusively in a hospital setting.
3. For anaphylactic shock, a 1% solution of adrenaline is administered intravenously and sublingually. After this, it is administered drip-wise.
4. It is advisable to use Dexamethasone.
5. Application antihistamines- in the form of injections, then in the form of tablets.
6. Introduction of Eufillin.
7. At antishock therapy the use of plasma-substituting solutions is indicated.
8. To prevent cerebral edema, diuretics are used - Furosemide, Torasemide.
9. For the cerebral variant of the pathology, magnesium sulfate, Relanium, and Seduxen are prescribed.
10. Introduction shown hormonal drugs, in particular, Prednisolone.

Emergency medical care upon early admission of the patient to the hospital guarantees a favorable outcome of the disease.

The danger of anaphylactic shock

This most dangerous disease does not pass without consequences. After its symptoms are relieved, a person may still have the following symptoms:

• lethargy, weakness and apathy;
• persistent decrease in pressure;
• pain in the heart due to ischemia;
• demotion mental abilities because of oxygen starvation brain;
• development of infiltrates in the brain.

TO late consequences Anaphylactic shock includes the following:

• allergic myocarditis;
• kidney damage;
• generalized damage to the nervous system;
• Quincke's edema;
• allergic rash;
• damage to the respiratory system;
• lupus.

Prevention

Primary prevention of anaphylactic shock involves completely preventing the patient from coming into contact with the allergen. People at risk of an allergic reaction should completely avoid bad habits, do not eat foods that contain various chemical ingredients.

Secondary prevention includes:

• treatment of rhinitis, dermatitis, hay fever;
• timely allergy testing to identify potentially dangerous substances;
• anamnesis analysis;
• on title page medical card it is necessary to indicate the medications to which the patient is allergic;
• Before administering the medicine, sensitivity tests must be carried out.

Patients must carefully observe the rules of hygiene. Should be carried out regularly wet cleaning and ventilate the room to ensure the flow of moist air. At home, a person who suffers from allergies should have an anti-shock first aid kit with all the necessary list of anti-shock drugs. Emergency measures for allergic reactions should be known to the patient's family members.

Anaphylactic shock refers to the most dangerous conditions requiring immediate medical attention. Dangerous forms of anaphylactic shock require emergency treatment. The outcome of this disease depends on when treatment was started and the amount of medical care.

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