Anaphylactic Shock

Anaphylactic Shock

It is severe systemic hypersensitivity reaction to an allergen. - Drugs (antibiotics, dextran, radiological contrasts), - food (peanuts, shellfish, dairy) - insect stings and latex.

Release of vasoactive mediators from basophil & mast cells (histamine, kinins, prostaglandins).

Reaction mostly mediated by IgE, IgG, or complement.

Anaphylactic shock results from vasodilation, intravascular volume redistribution,capillary leak and a reduction in cardiac output

Treatment:

1. Inj. Adrenaline – 0.5 ml s.c (1 in. 10000 )
2. IV steroids and antihistamines.

Anaphylactic Shock

1. Stop administration of causative agent (drug/fluid)

2. Lie patient flat, feet elevated

3. Maintain airway and give 100% O2

4. Adrenaline (epinephrine): - 0.5–1.0 mg (0.5–1.0 ml of 1:1000) IM or - 50–100 μg (0.5–1.0 ml of 1:10 000) IV ( titrated against response)

5. Intravascular volume expansion with crystalloid or colloid

6. Second-line therapy: - Antihistamine: Chlorphenamine 10–20 mg slow IV - Corticosteroid: Hydrocortisone 200 mg IV