| ID | 211 |
|---|---|
| Name | ANAPHYLACTIC SHOCK |
| Cause | |
| Signs Symptoms | Shock occurs by injection of drugs or vaccine to those persons who are previously sensitized by those drugs or vaccines. Warning signs are flushing, itching and urticaria. Symptoms of more severe attack are wheezing, feeling of chest constriction, abdominal pain, nausea, vomiting, circulatory collapse, cardiac arrest, convulsion & finally death. |
| Diagnosis | |
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| Management | Management: A General measures- 1. Drugs (penicillin, histamin) or precipitating causes should be removed. 2. Patient should be in supine position (leg elevated 30°) 3. Clear airway to be ensured by endotracheal tube (tracheostomy- if needed) and aspiration of secretion. B. Specific measures- 1. Adrenaline (1:1000) inj. 1ml subcutaneously or i.m to combat shock, hypotension, bronchospasm, laryngeal oedema. This dose should be repeated at 15 minutes interval untill improvement occurs, if pt. is profoundly hypotensive < 80 mm Hg (systolic) then 3-5ml may be given i.v slowly. 2. Hydrocortisone hemisuccinate 100-200mg inj. i.v slowly followed by oral prednisolone 5mg 6 hourly to combat pulmonary oedema, to sensitize the blood vessels to the action of catecholamine. 3. Promethazine hydorchloride 10-20mg inj i.v very slowly for 5 minutes to counteract the effect of histamin. 4. Aminophylline 500mg inj. i.v very slowly for 5 minutes if there is evidence of continuing airways obstruction. 5. 35% O2- if there is cyanosis. 6. 5% dextrose normal saline or normal saline to manage shock, hypotension. If not controlled then isoprenaline or dopamine to be given. |
| Introduction | Shock occurs by injection of drugs or vaccine to those persons who are previously sensitized by those drugs or vaccines. Warning signs are flushing, itching and urticaria. |
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