Anaphylactic shock (anaphylaxis) is a condition caused by a sudden severe allergic reaction that is difficult to predict. It is a potentially life-threatening situation, so a rapid response is important. It occurs annually in approximately 1-3% people. Worldwide, the incidence of anaphylaxis is between 50 and 112 episodes per 100 000 people each year. People who were previously unaware of the allergy are at the highest risk of dying from anaphylactic shock, because they do not expect it and do not know how to react.
"The primary risk group is patients with a history of concussion. Such patients should have their diagnosis deepened and be provided with adrenaline, as another shock may occur in them," explains Professor Maciej Kupczyk, president-elect of the Polish Society of Allergology.
It is useful to know what to do in a shock situation, as it can save our lives or those of our loved ones - ideally, adrenaline should be administered intramuscularly as soon as possible. Fortunately, there are easy-to-use injectors available on the market which allow it to be administered quickly in the upper thigh, even through clothing. Adrenaline is a prescription drug, so it is a good idea to go to a doctor who will prescribe it, and to keep the purchased medicine with you at all times. Adrenaline injectors are easy to use.
It is important to stress that anaphylaxis can be experienced by any person, including those who have never had any allergies before. If a doctor determines that a person is at risk of anaphylaxis, he or she will write a prescription for adrenaline. Current European Resuscitation Council guidelines indicate that if the first dose does not improve within 5 minutes, a second dose should be given, so it is good practice to carry two packs with you.
What can cause anaphylactic shock?The most common cause of anaphylactic shock is food ingestion - they account for 33% of cases. In children, food causes up to 85% cases of anaphylaxis. Insect stings (19%) and medications (14%) are another factor causing shock. Occasionally, but far less frequently, anaphylaxis is triggered by cat, latex, cleaning products, environmental allergens or physical exertion.
Foods that can cause anaphylactic shock are mainly: peanuts, nuts, fish and seafood, cow's milk, soya, eggs and sesame3. Anaphylaxis can be triggered by insect bites - bees, wasps, hornets, ants - as well as drugs, mainly antibiotics of the penicillin group and non-steroidal anti-inflammatory drugs.
Anaphylaxis affects the respiratory system, skin, cardiovascular system, gastrointestinal system and nervous system. The reaction can occur in several minutes, and is sometimes very rapid and occurs within minutes after contact with the shock trigger. In 90% cases, it occurs within 30 minutes. In 80-90% patients, the first symptom of anaphylaxis is skin changes - there may be a rash, redness of the skin. This may be followed by a feeling of palpitations, difficulty breathing, a feeling of weakness, dizziness, nausea and vomiting.
People at risk, i.e. those who are aware of their food allergy and those who have previously experienced shock, should see a doctor to assess their risk of anaphylactic shock.
What to do in the event of shock?First of all, you should stop contact with the shock-causing agent (e.g. stop the administration of medication) and call the emergency services. Then, as soon as possible, adrenaline should be given intramuscularly in the outer thigh. After the injection of adrenaline, the prick site should be massaged for a few seconds. Ideally, the patient should lie on their back with their legs slightly elevated, unless the patient has difficulty breathing, in which case a sitting position would be better. For pregnant women and unconscious patients, the lateral fixed position is best.
"Adrenaline is the only drug that can stop anaphylactic shock, saving lives. In the case of shock, the critical situation is hypovolaemia, a disruption of the cardiovascular system. If adrenaline is not administered early enough, the possibility of providing help shrinks considerably. To administer adrenaline is to maintain cardiopulmonary function. Adrenaline stops the symptoms of shock and thus gives us time to give qualified help to the patient," explains Professor Jarosław Drobnik, MD, PhD, Vice President of the Polish Society of Family Medicine.
Adrenaline always at hand - in whom? The occurrence of anaphylactic shock is very difficult, and sometimes impossible to predict. This is why people at risk, i.e. those who have previously experienced shock, people with diagnosed allergies, should always have it with them.
"In people who have had an aggravated allergic reaction, even if it does not meet the criterion of anaphylactic shock, but was a food or medication reaction, I convince such patients to have adrenaline at home so that this medication can be administered at any time. As far as insects are concerned, we find out about the shock after the first insect bite, when the shock occurs. This is why I recommend that beekeepers or people who have orchards or lots of fruit trees have adrenaline in their home first aid kit. It is often a life-saving item. Adrenaline should also be had by people who are planning to go on holiday, especially abroad," adds Prof Jaroslaw Drobnik.
Source: isbzdrowie.co.uk