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ANAPHYLACTIC SHOCK What is it? •Serious life threatening allergic reaction that is rapid in action and may cause death. Causes: •Common causes include insects bite/stings, foods and medication Symptoms Skin •Itchiness rather burning sensation of skin •Generalized hives •Flushing &swelling of lips •Swelling of tongue or throat in about 20% swelling of face •Running nose &redness of conjunctiva •Skin may also go blue due to lack of oxygen Symptoms Respiratory: •Shortness of breath •wheezes caused by spasm of bronchial muscles and stridor is due to upper airways obstruction •Hoarsness &pain with swallowing or cough Cardiac: •Coronary artery spasm which may lead to myocardial infarction ,dysrrythmias &cardiac arrest caused by histamine release •Low blood pressure and fast or low heart rate •Rapid pulse Symptoms Others: •Abdominal pain ,diarrhea ,vomiting dizziness ,chest discomfort, slurred speech •Confusion ,headache ,anxiety •Urine incontinence ,pelvic pain Risk factors: People with ASTHMA ,ECZMA ,or ALLERGIC RHINITIS Sensitivity tests on blood Patch test Challenge test Elimination test Differetial diagnosis •Asthma :no rash or itching •Syncopy: No rash but pallor more marked •Panic attack : No rash but flushing more marked than hives Prevention • Avoidance of triggers such as specific foods , environment, medications • Desensitization to venoms e.g bee ,snake wasp, ants etc • Oral immunotherapy mainly in food allergy e.g milk ,egg, nuts ,peanuts • Preparedness: People prone to reaction are advised to wear a medical alert bracelet with all information or having a card • Parents are advised to inform schools of their child’s Allergy Treament •Anaphylaxis is an emergency condition that needs professional medical attention right away. Call 1122 •Check the person's airway, breathing, and circulation (the ABC's of Basic Life Support). A warning sign of dangerous throat swelling is a very hoarse or whispered voice, or coarse sounds when the person is breathing in air. If necessary, begin rescue breathing and CPR. •Calm and reassure the person. •If the allergic reaction is from a bee sting, scrape the stinger off the skin with something firm (such as a fingernail or plastic credit card). Do not use tweezers -- squeezing the stinger will release more venom. Treatment • If the person has emergency allergy medicine on hand, help the person take or inject the medication. Avoid oral medication if the person is having difficulty breathing. • Take steps to prevent shock. Have the person lie flat, raise the person's feet about 12 inches, and cover him or her with a coat or blanket. Do NOT place the person in this position if a head, neck, back, or leg injury is suspected, or if it causes discomfort. • Do NOT place a pillow under the person's head if he or she is having trouble breathing. This can block the airways. • Do NOT give the person anything by mouth if the person is having trouble breathing. Prognosis •Good when allergen is known and medical care available •If Allergen is not known but preventive care is available and good then prognosis is good •Death occurs usually in respiratory asphixia or cardiac symptoms •Poor prognosis in old age •Patient recovers in most cases if timely given care