Anaphylaxis shock
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Transcript of Anaphylaxis shock
Anaphylaxis Shock
Written by student dentist Tal Kaplan
Content: Notion Anaphylaxis shock Classification's Types of hypersensitivity
reaction's Etiology Pathophysiology Singe’s & Symptom’s Diagnosis First aid Treatment Prevention
Notion Anaphylaxis shockThe term derived from greek language ana – (without) , phylaxis – (protection). A sudden, severe allergic reaction characterized by a sharp drop in blood pressure, urticaria (skin rash), and breathing difficulties that is caused by exposure to a foreign substance, such as a drug or bee venom, after a preliminary or sensitizing exposure. The reaction may be fatal if emergency treatment is not achieved immediately, treatment including epinephrine injections. Also called anaphylactic shock.
Classification'sBy the Type of shock:
• Typical• Cardiac• Asthmatic• Cerebral• Abdominal
By type of development:
• Momentry• Easy• Medium• Grave
Type's of hypersensetivity reaction’s
Mast cell release
histamine and other mediators
Immediate hypersensitivi
ty
Antibodies directed
against cell or tissue antigens
Antibody-mediated
Antibody-antigen complex
deposit in blood
vessels
immune complex diseases
Reactions of T
lymphocytes
T cell-mediated diseases
Etiology
Idiopathic 37%Food 34%Drugs 20%Exercise 7%Latex, hormons, insect bites 2%
Etiology
Pharmlogic agents• Antibiotics (penicillin)
• Nonsteroidal anti-inflammatory drugs (Asprin)
• intravenous (IV) contrast agents
Stinging insects• Ants, bees,
hornets, wasps, and yellow jackets.
Food• Peanuts,
seafood, and wheat
Latex• Rare• No latex-
associated deaths
Pathophysiology First exposure Activation of TH2 cell → Stimulate IgE switiching
Allergen
TH2 Cell B Cell
Pathophysiology
First exposure IgE production
IgE secreting B cell IgE
First exposure IgE bind to mast cell
Pathophysiology
Second exposure Recognition Allergen
Pathophysiology
Second exposure Activation of mast cell to release
histamine and other mediators
Mediators
Allergen
Pathophysiology
Symptom's & Sing's• Typical type:
Dizziness weakness fainting
rapid, slow, or irregular heart rate
low blood pressure
Nausea vomitingcramps
Itcing swlling around the eyesItching flushing hives (urticaria)
swelling
Symptom's & Sing's• Respiratory type:
Difficulty breathing coughing chest tightness wheezing or
other sounds
increased mucus
production
throat swelling or itching change in voice or a sensation
of choking
Symptom's & Sing's• Cardiac type:
Dizziness weakness fainting
rapid, slow, or irregular heart rate low blood pressure
Symptom's & Sing's• Abdominal type:
Nausea vomiting
cramps diarrhea
DiagnosisThe diagnosis of anaphylaxis is based upon symptoms that occur suddenly after being exposed to a potential trigger.Usually in dental clinic it will be more hard to get conclusive diagnosis.
Differential diagnosis:• severe asthma attack• heart attack• panic attack• food poisoning- Those differential diagnosis are very similar to anaphylaxis shock and a doctor could get a wrong diagnosis due to lack of tools in reach to doctor hand.- An increased amount of tryptase protein can be measured in a blood sample collected during the first three hours after anaphylaxis symptoms have begun. - Tryptase levels are seldom elevated in food-induced anaphylaxis
First aidPlace patient in horizontal with legs up
position.
Establish and maintain airway.
Give oxygen via nasal airway as needed.
Place a tourniquet above the reaction site.
Epinephrine at the site of antigen injection.
Start IV to rise BP.
Treatment
• Adrenalina sol. – 0.1% 0.5 ml, if patient state doesn't improve in 10-15 min, we Introduce 1.0 ml more of sol.• Suprastine sol. – 2% 1ml.• Prednisolone sol. 30-60 mg (unique dose) or hydrocortisone 75-125 mg.• Caffeine sol. Or cordiamine, or corazoli – 20% 1-2 ml.• In case of bronchospasm: eupheline sol. – 2.4% 5-10 ml or galidore sol. – 2ml (i/m).• To maintain cardiac activity are given cardiac glycosides & diuretics: lazex sol. – 2-4 ml (i/v),Corglicon sol. – 0.06% 0.5-1 ml (i/v).• In case of cardiovascular insufficiency: strophantini sol. 0.05% 0.5-1 ml, mazatoni sol. 0.1% 1ml• Ionic sol. of NaCl 0.9% 400 ml or glucose sol. 5-10% 400 ml, in perfusion introduced dopaminsol. 200 gr or noradrenaline 0.1% 1ml.• Injection place should be infiltrated with adrenalin sol.• Artificial respiration with extern massage of the heart.
Prevention
Avoid the responsible allergen (e.g. food, drug, latex, etc.).
Keep an adrenaline kit (e.g. Epipen) and Benadryl on hand at all times.
Wear medic Alert bracelets .
Venom immunotherapy is highly effective in protecting insect-
allergic individuals.
THANK YOU, STUDENT DENTIST TAL KAPLAN