Anaphylactic Shock: Recognize, Act, Save a Life

What is Anaphylactic Shock?

Anaphylactic shock is an extremely severe, potentially fatal systemic allergic reaction that develops very rapidly after contact with an allergen. This is a medical emergency requiring immediate medical attention. Unlike mild allergic reactions, anaphylaxis affects multiple organ systems simultaneously, leading to a life-threatening drop in blood pressure, breathing difficulties, and other serious symptoms.

Causes of Anaphylaxis: What Can Trigger It?

Anaphylactic shock can be caused by various allergens. The most common triggers include:

• Food products: peanuts, tree nuts (almonds, cashews, walnuts), milk, eggs, soy, wheat, fish, and seafood.
• Insect stings: venom from bees, wasps, hornets, and fire ants.
• Medicines: antibiotics (especially penicillins), nonsteroidal anti-inflammatory drugs (NSAIDs), anesthetics, and contrast agents used in certain medical imaging tests.
• Latex: natural rubber found in medical gloves, balloons, and other products.
• Physical exertion: in rare cases, intense physical exercise, especially when combined with certain foods, can trigger anaphylaxis.
• Idiopathic anaphylaxis: when the cause of the reaction remains unknown.

It is important to remember that even a minimal amount of an allergen can cause a severe reaction in a sensitive person.

Signs and Symptoms of Anaphylactic Shock

Symptoms of anaphylactic shock develop rapidly, usually within a few minutes (sometimes up to an hour) after contact with the allergen. They can vary in severity, but always require immediate attention. Key signs include:

• Skin manifestations (most common):
  • Generalized urticaria (itchy rashes resembling nettle burns).
  • Skin redness, feeling of warmth.
  • Swelling (angioedema) of the face, lips, eyelids, tongue, throat.
  • Severe itching all over the body.
• Respiratory system:
  • Shortness of breath, difficulty breathing.
  • Wheezing or whistling respiration (stridor or rales).
  • Cough, feeling of tightness in the chest.
  • Hoarseness, difficulty swallowing.
  • A feeling of a "lump" in the throat due to laryngeal edema, which can lead to suffocation.
• Cardiovascular system:
  • A sharp drop in blood pressure (hypotension) leading to shock.
  • Rapid heartbeat (tachycardia).
  • Weakness, dizziness, pre-fainting state.
  • Paleness, cold sweat.
  • Loss of consciousness.
• Gastrointestinal tract:
  • Nausea, vomiting.
  • Severe abdominal cramps and pain.
  • Diarrhea.
• Nervous system:
  • Sense of anxiety, fear.
  • Confusion.
  • Loss of consciousness.

It is important to note that not all symptoms may be present simultaneously, and their sequence can vary. The rapid progression of even a few symptoms should raise concern and prompt immediate action.

First Aid for Anaphylactic Shock: Act Immediately!

If anaphylactic shock is suspected, every second counts. Immediate and correct actions can save a person's life:

1. Call an ambulance (103 or 112): This is the first and most crucial step. Clearly inform the dispatcher about the suspected anaphylactic shock and the victim's location.
2. Administration of adrenaline (epinephrine):
   • If the victim carries an adrenaline auto-injector (such as an EpiPen), use it immediately. Follow the instructions on the package.
   • Adrenaline is injected intramuscularly into the outer thigh. This can be done even through clothing.
   • Hold the injector in place for a few seconds (usually 5-10), then remove it.
   • If symptoms do not improve or worsen after 5-15 minutes, a second dose of adrenaline can be administered if available.
3. Positioning of the victim:
   • Lay the person flat on their back with legs elevated to improve blood flow to vital organs (if there are no breathing problems).
   • If the victim is experiencing severe shortness of breath, help them assume a semi-sitting position.
   • If the person is unconscious or vomiting, lay them on their side in the recovery position to prevent aspiration of vomit.
4. Ensure airway patency: Loosen tight clothing around the neck and chest.
5. Do not leave the victim alone: Continue to monitor their condition until the ambulance arrives. Track breathing, pulse, and level of consciousness.
6. Remove the trigger (if possible): If the reaction is caused by an insect sting, carefully remove the stinger if it remains in the skin.

Even after administering adrenaline and improving the condition, the victim must be taken to the hospital for further observation and treatment, as a recurrent episode is possible (biphasic anaphylaxis).

When to Call an Ambulance?

An ambulance must be called for any suspected anaphylactic shock. Do not wait for symptoms to become severe. Even mild initial manifestations can progress rapidly. If a person has a known allergy and has been exposed to the allergen, or if they suddenly develop multiple symptoms from different organ systems (e.g., skin rash and difficulty breathing), call emergency services immediately. Always report the administration of adrenaline.

Prevention and Living with the Risk of Anaphylaxis

For individuals at risk of anaphylaxis, preventive measures are critical:

• Identification and avoidance of triggers: Consult an allergist for precise allergen testing. Carefully read food labels, and warn about your allergy in restaurants and when communicating with others.
• Always carry an adrenaline auto-injector: Ensure the medication has not expired. Carry it with you constantly and always have a spare.
• Educating others: Tell family members, friends, colleagues, and teachers about your allergy and teach them how to properly use the auto-injector.
• Medical bracelet/card: Wear a medical bracelet or carry a card with information about your allergy and emergency contacts.
• Anaphylaxis action plan: Work with your doctor to develop an individualized anaphylaxis action plan that includes a list of symptoms and step-by-step emergency instructions.
• Regular consultations with an allergist-immunologist: To monitor your condition and update your treatment plan.

Sources

1. An Unusual Presentation of Acute Pancreatitis with Atrial Fibrillation: A Case Report.
2. When Time Rules Out Certainty: Intravenous Tenecteplase in Acute Global Aphasia in a Young Woman with Subsequent Post-Anaphylactic Diagnostic Reorientation.
3. Clinical Features of Abdominal Migraine: A Systematic Review and Data Synthesis of 662 Patients.
4. Acute Confusional Migraine: Case Reports and Discussion as a Distinct Nosological Entity.
5. Early Analgesia for the Treatment of Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
6. Atypical Presentation of Acute Myocardial Infarction as Syncope and Abdominal Pain in the Absence of Chest Pain or Discomfort.
7. Acute Esophageal Necrosis in Patients with Diabetic Ketoacidosis: A Systematic Review of Clinical Features and Outcomes.
8. Incomplete Brown-Séquard Syndrome Secondary to Hematomyelia Induced by Acenocoumarol: A Case Report.

Disclaimer: The information provided in this article is for reference purposes only and cannot replace professional consultation, diagnosis, or treatment provided by a qualified medical professional. Always seek the advice of your physician or other health provider with any questions you may have regarding a medical condition or health status.