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Acute anaphylaxis
The acute anaphylaxis is, as a rule, acute and system allergic reaction which is characterized by prompt development with symptoms of asthma and sharp pressure decline. The expressed cardiovascular and respiratory insufficiency is life-threatening the patient.
The origin of an acute anaphylaxis is caused by repeated contact with allergen. Development of reaction depends on sensitivity of an organism. So, in certain cases reaction comes within two minutes after contact, but its development and within several hours is possible. Very often acute anaphylaxis appears at an allergy to stings of insects, at reception of proteinaceous food or administration of medicines on which allergic reactions were observed earlier.
Differences of an acute anaphylaxis from similar allergic reactions, its systemacity, that is involvement of several bodies, and weight of an illness. Without the timely help such reactions come to an end letalno. The acute anaphylaxis as complication of a medicinal allergy arises on antibiotics, anesthetics, nonsteroid antiinflammatory drugs, vaccines, X-ray contrast means. The disease can arise even at test of these drugs on reaction.
Symptoms of an acute anaphylaxis
Usually, the acute anaphylaxis is characterized by the fact that its symptoms are shown serially. As a rule, the first visual symptoms are the skin itch and the small tortoiseshell though in certain cases the small tortoiseshell can be absent. Further there is irritation in a throat, hoarse "asthmatic" breath and cough, as a result of quickly developing bronchial tube — and a laryngospasm, development and progressing of a Quincke's edema is possible. Also, sharply and suddenly arterial pressure decreases.
Very often there are such general symptoms of an acute anaphylaxis as feeling of heat, a sonitus, the complicated breath, pains of the head and in retrosternal area. During reaction of people it is excited, uneasy, but in rare instances can be and vice versa sluggish, suppressed. It is worth noticing that it is dependent how there is a development of this morbid condition in the patient muscular spasms can be observed.
Acute management at an acute anaphylaxis
The first that needs to be made, in a type of an opportunity – urgently to stop intake of allergen in an organism. For example, if the allergy develops because of sting, the applying a tourniquet slightly over the place of a sting in 1-2 cm and applying of ice to the place of an entrance of a sting of an insect in that case will be reasonable. Thereby considerably intake of allergen in the general flow of blood stops and development of an acute anaphylaxis is slowed down. Urgently the crew of "Ambulance" is caused, and meanwhile the patient is settled in situation on a back and exempted from the pressing and squeezing clothes (a tie, collars), thereby is provided with oxygen access. At possible vomiting the head of the patient needs to be turned on one side to exclude aspiration owing to sticking of language or emetic masses.
Treatment of an acute anaphylaxis
Treatment of an acute anaphylaxis just as also other allergic states, is symptomatic. To the patient parenterally, that is subcutaneously, and best of all intravenously it is entered from 0.2ml and to 0.5 ml of 0.1% of Epinephrinum in the form of a hydrochloride (adrenaline solution). It is the first acute management at an acute anaphylaxis therefore people inclined to an allergy should have this medicine at themselves. If necessary it is possible to repeat adrenaline injections, but surely controlling heart rate and breath.
After the above-stated drug glucocorticoids, for example Prednisolonum in a dosage of 150 mg are entered. Also necessary action in such process as adequate treatment of an acute anaphylaxis will be use of antihistaminic drugs, that is that which reduce allergic reaction. The list of these drugs includes a Dimedrol, Suprastinum, tavegil and other antihistaminic this row. At asthma total oxygenation of the patient an oxygen cushion, with the subsequent slow introduction intravenously of 2.4% of aqueous solution of an Euphyllinum, in a dosage from 10 to 20 ml is applied to removal of symptoms of oxygen insufficiency.
Prevention of an acute anaphylaxis
As emergence of reaction cannot almost be prevented prevention of an acute anaphylaxis, first of all, consists in that to limit contact of the patient with obviously known allergens. Also, when carrying out test on medicines it is necessary to watch attentively the patient and in case of manifestation of the first symptoms of an allergy – immediately to take the appropriate measures of first-aid treatment and treatment.
Section: Allergology