Anaphylaxis and things to avoid
According to doctors, anaphylactic shock is one of the most dangerous immediate allergic reactions, which can cause rapid death within a few minutes.
The public is wondering why two patients (one male, one female) suddenly died at Tri Duc General Hospital at 219 Le Duan Street, Hai Ba Trung District, Hanoi due to suspected anaphylactic shock. So how dangerous is anaphylactic shock to the patient's life and how to avoid it?
According to doctors, anaphylactic shock is one of the most dangerous immediate allergic reactions, which can cause rapid death within a few minutes.
It affects many of the patient's organ systems at the same time, resulting from the massive release of chemical mediators from the cells. Many different causes can cause anaphylaxis, but the most common are drugs, foods, chemicals, and insect venom.
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Dr. Tran Van Phuc, Xanh Pon Hospital (Hanoi) emphasized: “Anaphylaxis is a field that all medical staff from doctors to nurses must remember and learn by heart. This is a fundamental issue of medicine. We often require staff to learn by heart anytime, anywhere.”
It is estimated that 1-2% of the world's population has at least one anaphylactic shock (SPV) in their lifetime, with 4-5 cases of SPV per 10,000 people in Europe and 58.9 cases per 100,000 people in the US in recent years. The mortality rate of anaphylactic shock is estimated at 1%.
According to Bach Mai Hospital, in the medical field, all drugs can cause anaphylaxis and lead to death regardless of the route of administration, the most common being beta-lactam antibiotics, anti-inflammatory pain relievers, vaccines, serums, iodinated contrast agents and some anesthetics. In particular, the SPV rate of drugs is 37/100,000 patients taking the drug. Anaphylactic shock due to penicillin is about 10-50/100,000 doses and the mortality rate is 1-2/100,000 treatment doses.
Causes of anaphylactic shock
Medicine:There are many causes, of which drugs are the leading cause, followed by food and insect venom. Any drug can cause allergies such as: anti-inflammatory pain relievers, muscle relaxants, anticonvulsants, contrast agents, anesthetics, sedatives... but the most common are antibiotics, especially beta-lactam antibiotics (penicillin, ampicillin, amoxycillin)...
Food: Foods of animal and plant origin that can cause anaphylactic shock include: mackerel, tuna, shrimp, prawns, snails, pupae, eggs, milk, pineapple, potatoes, peanuts, soybeans, nuts and additives.
Insect venom:When bitten by insects such as bees, snakes, centipedes, scorpions, spiders, etc.
Symptom:
Immediately after exposure to the allergen or later, unusual feelings such as restlessness, panic, fear appear, followed by symptoms in one or more organs:
- Shivering
- Skin, mucous membranes: rash, erythema, hives, cold pale skin, sweating
- Cardiovascular: fast, weak, difficult to detect pulse, low or unmeasurable blood pressure.
- Respiratory: difficulty breathing (asthma, laryngitis), suffocation.
- Abdominal cramps, fecal incontinence.
- Headache, dizziness, sometimes coma
- Dizziness, struggling, writhing, convulsions
How to treat anaphylactic shock:
Medical experts recommend immediately stopping allergen exposure (injection, oral, topical, eye drops, nasal drops, etc.). At the same time, keep the patient in place, keep warm, head lower than feet, lie on the side if vomiting occurs. Adrenaline is the basic drug to prevent anaphylactic shock and must be used immediately. We can inject the drug intramuscularly 3 times with an interval of <5 minutes, if after each intramuscular injection the shock has not yet been relieved. In addition, adrenaline can be used to automatically determine the standard dose, 0.3 mg for adults and 0.15 mg for children, injected in the front side of the face.
In case the shock condition does not improve after 3 intramuscular injections, establish an intravenous adrenaline infusion immediately, starting at 0.1 ug/kg/min (about 0.3 mg/hr in adults), adjusting the infusion rate according to blood pressure, up to a maximum dose of 2-3 mg/hr for adults. It is best to administer via an electric syringe pump or infusion machine, intravenous drip can be used.
Anaphylaxis prophylaxis:
According to an expert in clinical allergy and immunology (Bach Mai Hospital), to prevent and minimize complications and deaths caused by anaphylactic shock, doctors and medical facilities need to implement a number of requirements such as: when examining a patient, the doctor must carefully exploit the patient's allergy history, pay attention to diseases such as bronchial asthma, allergic rhinitis, itching or anaphylactic shock caused by drugs...
The physician must carefully exploit the patient's allergy history, record the patient's allergy history information in the medical record or medical examination number. When discovering that the patient has a history of allergy or anaphylactic shock to a drug or allergen, the physician must provide the patient.
The allergy monitoring form clearly states the drug and allergen causing the allergy. Remind the patient to give this form to the doctor every time they see a doctor…/.
According to VOV