-
Anaphylaxis, Animation
(USMLE topics) Anaphylaxis (incl. anaphylactic shock): etiology, pathophysiology, symptoms and treatment. Anaphylaxis versus anaphylactoid reactions.
Purchase a license to download a non-watermarked version of this video on AlilaMedicalMedia(dot)com
Check out our new Alila Academy - AlilaAcademy(dot)com - complete video courses with quizzes, PDFs, and downloadable images.
All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
©Alila Medical Media. All rights reserved.
Voice by : Marty Henne
Anaphylaxis is a sudden, potentially life-threatening allergic reactio...
published: 23 Feb 2021
-
Anaphylactic Shock (Anaphylaxis) Treatment, Nursing Interventions, Symptoms NCLEX
Anaphylactic shock nursing review of the treatment, signs and symptoms, nursing interventions for anaphylaxis and anaphylactoid shock reactions.
Anaphylactic shock occurs when an allergen causes the mast cells or basophils to release massive amount of histamine and other mediators system-wide. This leads to a decrease in tissue perfusion to cells.
The release of histamine causes vasodilation, increased capillary permeability, bronchoconstriction, increased gastric secretions and smooth muscle contraction.
Signs and symptoms of anaphylactic shock include: difficulty breathing, inability to speak, swelling, wheezing, runny nose, watery eyes, hypotension, increased heart rate, itchy skin, diarrhea, nausea, vomiting etc.
Treatment and nursing interventions for anaphylactic shock include: r...
published: 18 Feb 2019
-
Be Safe from Anaphylaxis-Mayo Clinic
Every year up to two thousand people in the United States and Canada die from anaphylaxis -- a serious allergic reaction. The most common causes are allergies to peanuts, insect bites and seafood. But not all anaphylactic reactions are severe. They can be mild with subtler symptoms. And most people don't know that if you've had a mild reaction in the past, you're at risk of having a life threatening one in the future. More from Mayo Clinic on a new anaphylaxis awareness campaign.
published: 23 May 2008
-
A Wakeup Call – Heather’s Story of Anaphylaxis
Heather Braverman, age 19, shares her experience with an anaphylactic reaction and what she learned about not hesitating to use epinephrine, the first line treatment for anaphylaxis.
Heather was diagnosed with a nut allergy when she was just two years old, and avoided severe allergic reactions for 16 years. Then, when she was 18 she was eating dinner at a restaurant and started having symptoms. After taking an antihistamine, she went to the hospital, where her symptoms progressed and her throat began to close. At that point she was given a dose of epinephrine, which immediately alleviated her symptoms.
Dr. Scott Sicherer, pediatric allergist at the Jaffe Food Allergy Institute comments on how you shouldn't wait until your throat is closing or you feel faint to use epinephrine, as the med...
published: 20 Apr 2016
-
Anaphylaxis
published: 24 Sep 2019
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Anaphylaxis, Causes and treatment
Anaphylactic (allergic) shock is also referred to as anaphylaxis. As the clinical features present within a few minutes of exposure to an antigen it is classified as a severe form of type 1 hypersensitivity reaction. It is an extreme abnormal allergic reaction to a drug or other substance introduced into the body. Reactions usually present suddenly, within seconds to a few minutes after exposure to the antigenic substance. However, reactions delayed by up to half an hour may occur. When a person is first exposed to a substance to which they are hypersensitive, the B lymphocytes will produce antibodies. These antibodies become attached to mast cells. On subsequent exposure to the antigenic substance the antigen will combine with these antibodies causing the mast cells to release large amoun...
published: 25 Sep 2019
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Anaphylactic shock | Circulatory System and Disease | NCLEX-RN | Khan Academy
Created by Ian Mannarino.
Watch the next lesson: https://www.khanacademy.org/test-prep/nclex-rn/rn-cardiovascular-diseases/rn-shock-2/v/dissociative-shock?utm_source=YT&utm_medium=Desc&utm_campaign=Nclex-rn
Missed the previous lesson? https://www.khanacademy.org/test-prep/nclex-rn/rn-cardiovascular-diseases/rn-shock-2/v/obstructive-shock?utm_source=YT&utm_medium=Desc&utm_campaign=Nclex-rn
NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/by-nc-sa/3.0/us/).
About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that em...
published: 25 Nov 2014
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First Aid Skills: Anaphylaxis
#NXEssentials
published: 05 Apr 2018
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ANAPHYLAXIS EXPLAINED IN 3 MINUTES | CAUSE , MECHANISM, SYMPTOMS, TREATMENT - ANAPHYLACTIC SHOCK
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published: 06 Jun 2017
3:40
Anaphylaxis, Animation
(USMLE topics) Anaphylaxis (incl. anaphylactic shock): etiology, pathophysiology, symptoms and treatment. Anaphylaxis versus anaphylactoid reactions.
Purchas...
(USMLE topics) Anaphylaxis (incl. anaphylactic shock): etiology, pathophysiology, symptoms and treatment. Anaphylaxis versus anaphylactoid reactions.
Purchase a license to download a non-watermarked version of this video on AlilaMedicalMedia(dot)com
Check out our new Alila Academy - AlilaAcademy(dot)com - complete video courses with quizzes, PDFs, and downloadable images.
All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
©Alila Medical Media. All rights reserved.
Voice by : Marty Henne
Anaphylaxis is a sudden, potentially life-threatening allergic reaction that involves multiple system dysfunction. It is caused by a massive release of inflammatory mediators from mast cells and basophils into the circulation. These mediators are normally responsible for the body’s protective response against infections or injuries. They dilate blood vessels, increase their permeability, allowing immune cells to seep through to arrive at the site of infection. But when released systemically, they can lead to extensive vasodilation and smooth muscle spasms, causing blood pressure to drop and airways to narrow to a dangerous level.
Common triggers include certain medications, foods, insect stings, animal venoms, and latex.
Symptoms typically begin within minutes to one hour of exposure, and may include widespread itching, hives, swelling, wheezing and difficulty breathing, nausea, abdominal cramps, diarrhea, dizziness, a fast heart rate and low blood pressure. Shock may develop within minutes, patients may have seizures or faint.
There is also a late phase response, usually less severe, within several hours to one day.
Classically, anaphylaxis is defined as a type I hypersensitivity, which involves immunoglobulin E, IgE, and only occurs in presensitized individuals. Patients must have had a previous contact with the allergen, which produced no symptoms, but during which the body had produced IgE antibodies against the allergen. IgE molecules bind to their receptors on the surface of mast cells and basophils. Upon reexposure to the same allergen, or sometimes a similar allergen, the allergen binds to adjacent IgE molecules, bringing their receptors together, triggering a signaling cascade that induces the release of inflammatory chemicals.
There are also anaphylactoid reactions which are clinically indistinguishable from anaphylaxis but do not involve IgE and do not require prior sensitization. They occur via direct stimulation of mast cells or basophils, in the absence of immunoglobulins, and have different triggers. These reactions are now classified as “non-immunologic anaphylaxis”, as they are equally serious and must be treated the same way, with the same urgency.
Immediate injection of epinephrine is the cornerstone treatment for anaphylaxis. Epinephrine increases blood flow, widens airways and may help relieve all symptoms, at least temporarily. Other treatments may include antihistamines, oxygen therapy or intubation, intravenous fluids, beta-agonists, or vasopressors.
The best way to prevent anaphylaxis is to avoid the triggers. People with serious reactions to unavoidable allergens may benefit from immunotherapy. In immunotherapy, patients are injected weekly with gradually increasing doses of the allergen, starting with a tiny amount. This process desensitizes the immune system, reducing reactions to the allergen, but may take several years to complete.
https://wn.com/Anaphylaxis,_Animation
(USMLE topics) Anaphylaxis (incl. anaphylactic shock): etiology, pathophysiology, symptoms and treatment. Anaphylaxis versus anaphylactoid reactions.
Purchase a license to download a non-watermarked version of this video on AlilaMedicalMedia(dot)com
Check out our new Alila Academy - AlilaAcademy(dot)com - complete video courses with quizzes, PDFs, and downloadable images.
All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
©Alila Medical Media. All rights reserved.
Voice by : Marty Henne
Anaphylaxis is a sudden, potentially life-threatening allergic reaction that involves multiple system dysfunction. It is caused by a massive release of inflammatory mediators from mast cells and basophils into the circulation. These mediators are normally responsible for the body’s protective response against infections or injuries. They dilate blood vessels, increase their permeability, allowing immune cells to seep through to arrive at the site of infection. But when released systemically, they can lead to extensive vasodilation and smooth muscle spasms, causing blood pressure to drop and airways to narrow to a dangerous level.
Common triggers include certain medications, foods, insect stings, animal venoms, and latex.
Symptoms typically begin within minutes to one hour of exposure, and may include widespread itching, hives, swelling, wheezing and difficulty breathing, nausea, abdominal cramps, diarrhea, dizziness, a fast heart rate and low blood pressure. Shock may develop within minutes, patients may have seizures or faint.
There is also a late phase response, usually less severe, within several hours to one day.
Classically, anaphylaxis is defined as a type I hypersensitivity, which involves immunoglobulin E, IgE, and only occurs in presensitized individuals. Patients must have had a previous contact with the allergen, which produced no symptoms, but during which the body had produced IgE antibodies against the allergen. IgE molecules bind to their receptors on the surface of mast cells and basophils. Upon reexposure to the same allergen, or sometimes a similar allergen, the allergen binds to adjacent IgE molecules, bringing their receptors together, triggering a signaling cascade that induces the release of inflammatory chemicals.
There are also anaphylactoid reactions which are clinically indistinguishable from anaphylaxis but do not involve IgE and do not require prior sensitization. They occur via direct stimulation of mast cells or basophils, in the absence of immunoglobulins, and have different triggers. These reactions are now classified as “non-immunologic anaphylaxis”, as they are equally serious and must be treated the same way, with the same urgency.
Immediate injection of epinephrine is the cornerstone treatment for anaphylaxis. Epinephrine increases blood flow, widens airways and may help relieve all symptoms, at least temporarily. Other treatments may include antihistamines, oxygen therapy or intubation, intravenous fluids, beta-agonists, or vasopressors.
The best way to prevent anaphylaxis is to avoid the triggers. People with serious reactions to unavoidable allergens may benefit from immunotherapy. In immunotherapy, patients are injected weekly with gradually increasing doses of the allergen, starting with a tiny amount. This process desensitizes the immune system, reducing reactions to the allergen, but may take several years to complete.
- published: 23 Feb 2021
- views: 223286
19:32
Anaphylactic Shock (Anaphylaxis) Treatment, Nursing Interventions, Symptoms NCLEX
Anaphylactic shock nursing review of the treatment, signs and symptoms, nursing interventions for anaphylaxis and anaphylactoid shock reactions.
Anaphylactic s...
Anaphylactic shock nursing review of the treatment, signs and symptoms, nursing interventions for anaphylaxis and anaphylactoid shock reactions.
Anaphylactic shock occurs when an allergen causes the mast cells or basophils to release massive amount of histamine and other mediators system-wide. This leads to a decrease in tissue perfusion to cells.
The release of histamine causes vasodilation, increased capillary permeability, bronchoconstriction, increased gastric secretions and smooth muscle contraction.
Signs and symptoms of anaphylactic shock include: difficulty breathing, inability to speak, swelling, wheezing, runny nose, watery eyes, hypotension, increased heart rate, itchy skin, diarrhea, nausea, vomiting etc.
Treatment and nursing interventions for anaphylactic shock include: removing the allergen, administering epinephrine, placing the patient in the supine position with the leg elevated, education etc.
#anaphylacticshock #shock #anaphylaxis
Quiz: https://www.registerednursern.com/anaphylactic-shock-nclex-questions/
Notes: https://www.registerednursern.com/anaphylactic-shock-nclex-review/
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Nursing School Tips & Questions" https://www.youtube.com/playlist?list=PLQrdx7rRsKfVQok-t1X5ZMGgQr3IMBY9M
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New Nurse Tips: https://www.youtube.com/playlist?list=PLQrdx7rRsKfVTqH6LIoAD2zROuzX9GXZy
Nursing Career Help: https://www.youtube.com/playlist?list=PLQrdx7rRsKfVXjptWyvj2sx1k1587B_pj
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Diabetes Health Managment: https://www.youtube.com/playlist?list=PLQrdx7rRsKfXtEx17D7zC1efmWIX-iIs9
https://wn.com/Anaphylactic_Shock_(Anaphylaxis)_Treatment,_Nursing_Interventions,_Symptoms_Nclex
Anaphylactic shock nursing review of the treatment, signs and symptoms, nursing interventions for anaphylaxis and anaphylactoid shock reactions.
Anaphylactic shock occurs when an allergen causes the mast cells or basophils to release massive amount of histamine and other mediators system-wide. This leads to a decrease in tissue perfusion to cells.
The release of histamine causes vasodilation, increased capillary permeability, bronchoconstriction, increased gastric secretions and smooth muscle contraction.
Signs and symptoms of anaphylactic shock include: difficulty breathing, inability to speak, swelling, wheezing, runny nose, watery eyes, hypotension, increased heart rate, itchy skin, diarrhea, nausea, vomiting etc.
Treatment and nursing interventions for anaphylactic shock include: removing the allergen, administering epinephrine, placing the patient in the supine position with the leg elevated, education etc.
#anaphylacticshock #shock #anaphylaxis
Quiz: https://www.registerednursern.com/anaphylactic-shock-nclex-questions/
Notes: https://www.registerednursern.com/anaphylactic-shock-nclex-review/
Nursing Gear: https://teespring.com/stores/registerednursern
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Subscribe: http://www.youtube.com/subscription_center?add_user=registerednursern
Nursing School Supplies: http://www.registerednursern.com/the-ultimate-list-of-nursing-medical-supplies-and-items-a-new-nurse-student-nurse-needs-to-buy/
Popular Playlists:
NCLEX Reviews: https://www.youtube.com/playlist?list=PLQrdx7rRsKfWtwCDmLHyX2UeHofCIcgo0
Fluid & Electrolytes: https://www.youtube.com/playlist?list=PLQrdx7rRsKfWJSZ9pL8L3Q1dzdlxUzeKv
Nursing Skills: https://www.youtube.com/playlist?list=PLQrdx7rRsKfUhd_qQYEbp0Eab3uUKhgKb
Nursing School Study Tips: https://www.youtube.com/playlist?list=PLQrdx7rRsKfWBO40qeDmmaMwMHJEWc9Ms
Nursing School Tips & Questions" https://www.youtube.com/playlist?list=PLQrdx7rRsKfVQok-t1X5ZMGgQr3IMBY9M
Teaching Tutorials: https://www.youtube.com/playlist?list=PLQrdx7rRsKfUkW_DpJekN_Y0lFkVNFyVF
Types of Nursing Specialties: https://www.youtube.com/playlist?list=PLQrdx7rRsKfW8dRD72gUFa5W7XdfoxArp
Healthcare Salary Information: https://www.youtube.com/playlist?list=PLQrdx7rRsKfVN0vmEP59Tx2bIaB_3Qhdh
New Nurse Tips: https://www.youtube.com/playlist?list=PLQrdx7rRsKfVTqH6LIoAD2zROuzX9GXZy
Nursing Career Help: https://www.youtube.com/playlist?list=PLQrdx7rRsKfVXjptWyvj2sx1k1587B_pj
EKG Teaching Tutorials: https://www.youtube.com/playlist?list=PLQrdx7rRsKfU-A9UTclI0tOYrNJ1N5SNt
Dosage & Calculations for Nurses: https://www.youtube.com/playlist?list=PLQrdx7rRsKfUYdl0TZQ0Tc2-hLlXlHNXq
Diabetes Health Managment: https://www.youtube.com/playlist?list=PLQrdx7rRsKfXtEx17D7zC1efmWIX-iIs9
- published: 18 Feb 2019
- views: 387982
2:49
Be Safe from Anaphylaxis-Mayo Clinic
Every year up to two thousand people in the United States and Canada die from anaphylaxis -- a serious allergic reaction. The most common causes are allergies t...
Every year up to two thousand people in the United States and Canada die from anaphylaxis -- a serious allergic reaction. The most common causes are allergies to peanuts, insect bites and seafood. But not all anaphylactic reactions are severe. They can be mild with subtler symptoms. And most people don't know that if you've had a mild reaction in the past, you're at risk of having a life threatening one in the future. More from Mayo Clinic on a new anaphylaxis awareness campaign.
https://wn.com/Be_Safe_From_Anaphylaxis_Mayo_Clinic
Every year up to two thousand people in the United States and Canada die from anaphylaxis -- a serious allergic reaction. The most common causes are allergies to peanuts, insect bites and seafood. But not all anaphylactic reactions are severe. They can be mild with subtler symptoms. And most people don't know that if you've had a mild reaction in the past, you're at risk of having a life threatening one in the future. More from Mayo Clinic on a new anaphylaxis awareness campaign.
- published: 23 May 2008
- views: 403006
4:39
A Wakeup Call – Heather’s Story of Anaphylaxis
Heather Braverman, age 19, shares her experience with an anaphylactic reaction and what she learned about not hesitating to use epinephrine, the first line trea...
Heather Braverman, age 19, shares her experience with an anaphylactic reaction and what she learned about not hesitating to use epinephrine, the first line treatment for anaphylaxis.
Heather was diagnosed with a nut allergy when she was just two years old, and avoided severe allergic reactions for 16 years. Then, when she was 18 she was eating dinner at a restaurant and started having symptoms. After taking an antihistamine, she went to the hospital, where her symptoms progressed and her throat began to close. At that point she was given a dose of epinephrine, which immediately alleviated her symptoms.
Dr. Scott Sicherer, pediatric allergist at the Jaffe Food Allergy Institute comments on how you shouldn't wait until your throat is closing or you feel faint to use epinephrine, as the medicine needs time to circulate.
Heather learned from this experience that you must speak up for yourself and know exactly what to do in case of an allergic reaction. You don't want to leave it up to assumptions; work with your doctor to develop an emergency plan and to understand different scenarios and symptoms so you feel comfortable responding.
This powerful video is important to share with people with food allergies, especially teenagers, who are at the highest risk for fatal food allergy reactions.
Learn more about anaphylaxis at http://www.foodallergy.org/anaphylaxis
Download an Emergency Care Plan at http://www.foodallergy.org/faap
https://wn.com/A_Wakeup_Call_–_Heather’S_Story_Of_Anaphylaxis
Heather Braverman, age 19, shares her experience with an anaphylactic reaction and what she learned about not hesitating to use epinephrine, the first line treatment for anaphylaxis.
Heather was diagnosed with a nut allergy when she was just two years old, and avoided severe allergic reactions for 16 years. Then, when she was 18 she was eating dinner at a restaurant and started having symptoms. After taking an antihistamine, she went to the hospital, where her symptoms progressed and her throat began to close. At that point she was given a dose of epinephrine, which immediately alleviated her symptoms.
Dr. Scott Sicherer, pediatric allergist at the Jaffe Food Allergy Institute comments on how you shouldn't wait until your throat is closing or you feel faint to use epinephrine, as the medicine needs time to circulate.
Heather learned from this experience that you must speak up for yourself and know exactly what to do in case of an allergic reaction. You don't want to leave it up to assumptions; work with your doctor to develop an emergency plan and to understand different scenarios and symptoms so you feel comfortable responding.
This powerful video is important to share with people with food allergies, especially teenagers, who are at the highest risk for fatal food allergy reactions.
Learn more about anaphylaxis at http://www.foodallergy.org/anaphylaxis
Download an Emergency Care Plan at http://www.foodallergy.org/faap
- published: 20 Apr 2016
- views: 257846
34:47
Anaphylaxis, Causes and treatment
Anaphylactic (allergic) shock is also referred to as anaphylaxis. As the clinical features present within a few minutes of exposure to an antigen it is classifi...
Anaphylactic (allergic) shock is also referred to as anaphylaxis. As the clinical features present within a few minutes of exposure to an antigen it is classified as a severe form of type 1 hypersensitivity reaction. It is an extreme abnormal allergic reaction to a drug or other substance introduced into the body. Reactions usually present suddenly, within seconds to a few minutes after exposure to the antigenic substance. However, reactions delayed by up to half an hour may occur. When a person is first exposed to a substance to which they are hypersensitive, the B lymphocytes will produce antibodies. These antibodies become attached to mast cells. On subsequent exposure to the antigenic substance the antigen will combine with these antibodies causing the mast cells to release large amounts of histamine and other inflammatory and vasodilatory substances into the blood and tissue fluids. Histamine is a powerful vasodilator and bronchoconstrictor. Arteriole vasodilation reduces the peripheral resistance and therefore blood pressure. In addition to this the capillaries become more permeable so fluid leaks from the blood into the tissues, leading to oedema and hypovolaemia. Pulmonary oedema may also develop. Heart rate will usually increase in an attempt to compensate for the hypotension
Clinical features
Often the first indication of a developing reaction is patient anxiety and unease. This has been described as a feeling of impending doom. The severity of reactions may vary considerably from skin irritation and a feeling of unease to complete collapse. Indeed in young children the collapse has been of such severity that the child becomes completely flaccid, so called ‘rag doll’ syndrome. In addition to the hypotension and bronchospasm already described, angioedema may develop. This may affect the face, tongue and larynx resulting in progressive occlusion of the upper airway, compounding the respiratory embarrassment caused by the bronchospasm. These respiratory problems will lead to wheezing, distress, stridor and cyanosis. Because pathological vasodilation is caused by histamine and other substances, anaphylaxis often causes patchy or global redness of the skin. In addition to redness, intensely itchy urticarial wheals may develop. Sneezing and other irritation of the respiratory tract may be a feature. Young children rarely, if ever, faint after a medical procedure such as a vaccination, so any case of collapse in children will be organic in nature.
Adults however frequently faint, and so this is the most likely cause of acute unconsciousness. In a faint the patient regains consciousness very quickly when lying flat and there is no redness or wheals on the skin. A central pulse is maintained during a faint or convulsion. Central pulses should be palpated for 5 to 10 seconds as there is often a bradycardia during a faint. Anaphylactic reactions are more common in people with a history of allergy or previous reactions; there may also be a history of asthma. There is often a history of previous localized allergic reactions to the offending antigen. Gaining information about an individual’s allergies and any previous abnormal reactions
is therefore a vital part of a patient assessment. However, almost any agent may cause anaphylaxis in idiosyncratically sensitive individuals and present without warning.
Management principles in anaphylaxis
The causative agent should be identified and if possible discontinued or removed. Airway patency must be established and high concentrations of oxygen should be given if available. The patient should lie flat to maximize cerebral circulation. Intravenous fluids may be needed to improve blood pressure. If there is nocardiac output the situation may present as a cardiac arrest and then should be treated as such. Epinephrine (adrenaline) should be given promptly via deep intramuscular injection, normally an initial dose of 0.5mg for an adult with a corresponding reduced dose for children. This dose may be repeated after 5 to 10 minutes if indicated. Epinephrine is a potent bronchodilator and vasoconstrictor; it is therefore capable of reversing the principle effects of
histamine. (Inadvertent intravenous injection of a bolus dose of epinephrine may well lead to ventricular fibrillation so is one to avoid.) Chlorpheniramine (piriton), hydrocortisone and salbutamol may also play a role in management.
All patients who have had an anaphylactic reaction should be automatically admitted to hospital for review by a physician. Once the causative agent is identified patients must be instructed to avoid it in future. Patients should also be issued with self-injectible epinephrine and they and their relatives should be taught how and when to administer this. MedicAlert bracelets should be worn. Alert stickers should be placed on patients’ notes and prescription charts.
https://wn.com/Anaphylaxis,_Causes_And_Treatment
Anaphylactic (allergic) shock is also referred to as anaphylaxis. As the clinical features present within a few minutes of exposure to an antigen it is classified as a severe form of type 1 hypersensitivity reaction. It is an extreme abnormal allergic reaction to a drug or other substance introduced into the body. Reactions usually present suddenly, within seconds to a few minutes after exposure to the antigenic substance. However, reactions delayed by up to half an hour may occur. When a person is first exposed to a substance to which they are hypersensitive, the B lymphocytes will produce antibodies. These antibodies become attached to mast cells. On subsequent exposure to the antigenic substance the antigen will combine with these antibodies causing the mast cells to release large amounts of histamine and other inflammatory and vasodilatory substances into the blood and tissue fluids. Histamine is a powerful vasodilator and bronchoconstrictor. Arteriole vasodilation reduces the peripheral resistance and therefore blood pressure. In addition to this the capillaries become more permeable so fluid leaks from the blood into the tissues, leading to oedema and hypovolaemia. Pulmonary oedema may also develop. Heart rate will usually increase in an attempt to compensate for the hypotension
Clinical features
Often the first indication of a developing reaction is patient anxiety and unease. This has been described as a feeling of impending doom. The severity of reactions may vary considerably from skin irritation and a feeling of unease to complete collapse. Indeed in young children the collapse has been of such severity that the child becomes completely flaccid, so called ‘rag doll’ syndrome. In addition to the hypotension and bronchospasm already described, angioedema may develop. This may affect the face, tongue and larynx resulting in progressive occlusion of the upper airway, compounding the respiratory embarrassment caused by the bronchospasm. These respiratory problems will lead to wheezing, distress, stridor and cyanosis. Because pathological vasodilation is caused by histamine and other substances, anaphylaxis often causes patchy or global redness of the skin. In addition to redness, intensely itchy urticarial wheals may develop. Sneezing and other irritation of the respiratory tract may be a feature. Young children rarely, if ever, faint after a medical procedure such as a vaccination, so any case of collapse in children will be organic in nature.
Adults however frequently faint, and so this is the most likely cause of acute unconsciousness. In a faint the patient regains consciousness very quickly when lying flat and there is no redness or wheals on the skin. A central pulse is maintained during a faint or convulsion. Central pulses should be palpated for 5 to 10 seconds as there is often a bradycardia during a faint. Anaphylactic reactions are more common in people with a history of allergy or previous reactions; there may also be a history of asthma. There is often a history of previous localized allergic reactions to the offending antigen. Gaining information about an individual’s allergies and any previous abnormal reactions
is therefore a vital part of a patient assessment. However, almost any agent may cause anaphylaxis in idiosyncratically sensitive individuals and present without warning.
Management principles in anaphylaxis
The causative agent should be identified and if possible discontinued or removed. Airway patency must be established and high concentrations of oxygen should be given if available. The patient should lie flat to maximize cerebral circulation. Intravenous fluids may be needed to improve blood pressure. If there is nocardiac output the situation may present as a cardiac arrest and then should be treated as such. Epinephrine (adrenaline) should be given promptly via deep intramuscular injection, normally an initial dose of 0.5mg for an adult with a corresponding reduced dose for children. This dose may be repeated after 5 to 10 minutes if indicated. Epinephrine is a potent bronchodilator and vasoconstrictor; it is therefore capable of reversing the principle effects of
histamine. (Inadvertent intravenous injection of a bolus dose of epinephrine may well lead to ventricular fibrillation so is one to avoid.) Chlorpheniramine (piriton), hydrocortisone and salbutamol may also play a role in management.
All patients who have had an anaphylactic reaction should be automatically admitted to hospital for review by a physician. Once the causative agent is identified patients must be instructed to avoid it in future. Patients should also be issued with self-injectible epinephrine and they and their relatives should be taught how and when to administer this. MedicAlert bracelets should be worn. Alert stickers should be placed on patients’ notes and prescription charts.
- published: 25 Sep 2019
- views: 21264
8:30
Anaphylactic shock | Circulatory System and Disease | NCLEX-RN | Khan Academy
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Created by Ian Mannarino.
Watch the next lesson: https://www.khanacademy.org/test-prep/nclex-rn/rn-cardiovascular-diseases/rn-shock-2/v/dissociative-shock?utm_source=YT&utm_medium=Desc&utm_campaign=Nclex-rn
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Created by Ian Mannarino.
Watch the next lesson: https://www.khanacademy.org/test-prep/nclex-rn/rn-cardiovascular-diseases/rn-shock-2/v/dissociative-shock?utm_source=YT&utm_medium=Desc&utm_campaign=Nclex-rn
Missed the previous lesson? https://www.khanacademy.org/test-prep/nclex-rn/rn-cardiovascular-diseases/rn-shock-2/v/obstructive-shock?utm_source=YT&utm_medium=Desc&utm_campaign=Nclex-rn
NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/by-nc-sa/3.0/us/).
About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that empower learners to study at their own pace in and outside of the classroom. We tackle math, science, computer programming, history, art history, economics, and more. Our math missions guide learners from kindergarten to calculus using state-of-the-art, adaptive technology that identifies strengths and learning gaps. We've also partnered with institutions like NASA, The Museum of Modern Art, The California Academy of Sciences, and MIT to offer specialized content.
For free. For everyone. Forever. #YouCanLearnAnything
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- published: 25 Nov 2014
- views: 450185
3:48
ANAPHYLAXIS EXPLAINED IN 3 MINUTES | CAUSE , MECHANISM, SYMPTOMS, TREATMENT - ANAPHYLACTIC SHOCK
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- published: 06 Jun 2017
- views: 105310