How to get rid of anaphylactic shock. Anaphylactic shock consequences. Clinical manifestations of anaphylactic shock

Anaphylactic shock is a severe pathological condition caused by certain allergens.

Without immediate medical attention, shock can lead to irreversible changes in the body or death.

Therefore, it is necessary to know the signs of anaphylactic shock and how to provide first aid.

Anaphylactic shock often occurs in a generalized form, which is accompanied by various symptoms.

Patients experience fear, anxiety and general weakness. Itching, swelling, abdominal pain, etc. may appear.

But, depending on the main syndrome, there are 5 more forms of anaphylactic shock that have narrowly focused symptoms.

They are:

1. Asphyxia. It is characterized by laryngeal edema and the development of bronchospasms. Sometimes it can provoke pulmonary edema and oxygen deprivation.
2. Hemodynamic. In the clinical picture of the disease, a decrease in blood pressure, changes in the functions of the vegetative-vascular system and a decrease in the volume of circulating blood prevail.
3. Cerebral. It is characterized by the occurrence of convulsive syndrome, impaired consciousness and meningeal syndrome.
4. Thromboembolic. Differs in the occurrence of pulmonary embolism.
5. Abdominal. Symptoms of peritoneal irritation and severe abdominal pain appear.

If there is even the slightest suspicion of the development of anaphylactic shock, it is necessary to urgently call ambulance.

Causes of anaphylactic shock

There are a lot of allergens that can cause anaphylactic shock.

Experts conditionally divide them into several groups:

• Medicines. The most common cause of anaphylactic shock is penicillin. Even foods in which it is contained in small quantities can provoke an allergic reaction. Less commonly, anaphylaxis occurs due to Aspirin, muscle relaxants and anesthetics.
• Insect bites. The poison transmitted by bees or wasps can easily provoke allergies. Especially in young children or with a lot of bites.
• Food. The most dangerous to the body are peanuts, shellfish, slaves, nuts and eggs. In some cases, for the appearance of anaphylactic shock, it is enough to add food additives based on these allergens to the dish.
• Aeroallergens. A small percentage of the world's population is prone to allergic manifestations when pollen enters the respiratory system. This usually does not lead to anaphylaxis, but it is possible.
• Vaccines. Routine vaccinations against rubella, measles, tetanus, or other diseases can sometimes lead to anaphylactic shock. The reason lies in the intolerance of some components, for example, neomycin.
• Systemic mastocytosis. With this disease, the body produces a lot of immune cells that can provoke severe allergies.

Anaphylactic shock can be caused by animals, blood transfusions, plants, etc. It is almost impossible to identify the pathogen before the body's reaction appears.

The main symptoms

Anaphylactic shock most often occurs in children, since their fragile body is most susceptible to allergens.

In children

Signs of anaphylaxis in children are associated with the development of the disease. As soon as the allergen enters the body, the first symptoms begin to appear. If there was contact with the skin, then the child begins to itch.

If the reason is in products or drugs, then you may experience:

• fear and anxiety;
• severe headaches;
• noise in ears;
• hives;
• dyspnea;
• lowering blood pressure;
• convulsions;
• vomiting;
• loss of consciousness;
• foam at the mouth.

In adults

The signs of anaphylactic shock in adults are practically no different from those in children. Except for some signs, for example, bloody discharge from the genitals.

Development stages

Modern medicine distinguishes three main stages in the development of anaphylactic shock:

1. Immunological. This is the initial stage in the development of the disease, which occurs immediately after the allergen enters the body. At this time, a special sensitivity to this substance is formed. The immunological stage can last from several days to several years.
2. Immunochemical. At this stage, the allergen enters the body a second time, due to which the release of substances that provoke anaphylactic shock occurs.
3. Pathophysiological. An active effect of the allergen on the body occurs, thereby causing the external manifestations of an allergic reaction.

If a person is in the third stage, he cannot do without help, including medical help.

Dangers and complications

Anaphylactic shock is very dangerous, as it can even cause death. It is impossible to predict it, and it is rather difficult to help a person in such a state. Especially if the allergen has caused a severe stage of anaphylaxis. For example, if the patient has lost consciousness, then he may die from suffocation within half an hour. Or within a few days from irreversible damage to internal organs.

Anaphylaxis can lead to intestinal bleeding, cerebral hemorrhage, etc. The danger lies in the fact that usually an allergic reaction occurs in two phases. And after an attack, relief of the condition may occur, but after a while the patient feels a sharp deterioration. That is why in hospitals such patients are left under the supervision of doctors for at least two weeks.

Anaphylactic shock can proceed in different ways and has several stages of development. Follow the link in detail about the severity of a person's condition in a state of shock.

First aid

If a person has anaphylactic shock, he needs to be given first aid.

And the main thing that can be done is to get rid of the allergen. If it has entered the body through the stomach, then lavage should be done.

After that it is necessary to introduce intestinal sorbents, for example, activated carbon.

If the allergen gets through the mucous membrane, then it is washed with a weak salt solution.

And with an insect bite, you must:

• carefully remove the sting along with the poisonous bag;
• prick the bite with a solution of adrenaline, which is prepared as follows: dissolve 1 ml of adrenaline in 10 ml of sodium chloride. Adrenaline injections should be at least 5-6 (0.2-0.3 ml each);
• apply a cold compress to the bite site.

Stage first aid also includes the following activities:

• The patient should be placed on any horizontal surface.
• The patient's legs should be slightly higher.
• It is necessary that the patient has a constant supply of fresh air.
• You should ask the person what could be causing these symptoms.
• It is imperative to give an antihistamine, which allergy sufferers always use.

The rest should be done by doctors after examining the patient. Their duties in providing first aid include:

• Support for the work of the heart and respiratory system. If necessary, a tracheotomy or intubation is performed.
• Blood pressure support. With anaphylaxis, it can be greatly reduced, so doctors inject the appropriate drug.
• If the patient's condition worsens, a medical team performs resuscitation procedures.
• An obligatory stage in first aid is urgent hospitalization of the patient.

Before the arrival of doctors, it is necessary to measure the pulse of a patient with anaphylactic shock and monitor his breathing.

Treatment

In the hospital, the doctor prescribes the following drugs as treatment:

• adrenaline or epinephrine;
• glucocorticoids such as dexamethasone or prednisolone;
• as antihistamines Diphenhydramine, Tavegil or Suprastin.

All medications are administered using a dropper and an oxygen mask.

After the patient is withdrawn from anaphylactic shock, additional studies are prescribed. It is important to find out how the allergic reaction affected internal organs and general health. The patient must undergo such diagnostic measures as ultrasound, blood and urine tests, cardiogram, etc.

As a prevention of anaphylactic shock, experts advise allergy sufferers not to come into contact with allergens and always keep antihistamines with them. And at the first signs of anaphylaxis in a person, it is necessary to provide him with first aid and wait for the doctors.

Since anaphylactic shock is a life-threatening condition, it is a must. The article contains information about the algorithm for providing assistance.

What resuscitation measures are carried out for cardiogenic shock, read.

Video on the topic

Anaphylactic shock is an acute allergic process that develops in a sensitized body in response to repeated contact with an allergen and is accompanied by a violation of hemodynamics, leading to circulatory failure and, as a result, acute oxygen starvation vital organs.

Bronchospasm is one of the signs of anaphylactic shock

A sensitized organism is an organism that has previously been in contact with a provocateur and has increased sensitivity to it. In other words, anaphylactic shock, like any other allergic reaction, develops not on the first exposure to the allergen, but on the second or subsequent ones.

Shock is an immediate-type hypersensitivity reaction and is a life-threatening condition. A complete clinical picture of shock unfolds in a period from several seconds to 30 minutes.

For the first time, anaphylactic shock is mentioned in documents dated 2641 BC. e. According to records, the Egyptian pharaoh Menes died from an insect bite.

The first qualified description of the pathological condition was made in 1902 by the French physiologists P. Portier and C. Richet. In the experiment, after repeated immunization, a dog that had previously tolerated serum administration well developed acute shock with a lethal outcome instead of a preventive effect. To describe this phenomenon, the term anaphylaxis was introduced (from the Greek words ana - "reverse" and phylaxis - "protection"). In 1913, the named physiologists were awarded Nobel Prize in the field of medicine and physiology.

Diagnosis of anaphylactic shock is not difficult, since the connection of characteristic clinical manifestations with a previous insect bite, eating an allergenic product or using a drug is usually obvious.

Epidemiological data indicate that the incidence of anaphylactic shock in Russian Federation is 1 per 70,000 population per year. In patients with acute allergic diseases, it occurs in 4.5% of cases.

Synonym: anaphylaxis.

Causes and risk factors

Anaphylaxis can be caused by various substances, more often of a protein or polysaccharide nature. Low molecular weight compounds (haptens or incomplete antigens), which acquire allergenic properties when they bind to the host protein, can also provoke the development of a pathological condition.

The main provocateurs of anaphylaxis are as follows.

Medicines (up to 50% of all cases):

• antibacterial drugs (most often natural and semi-synthetic penicillins, sulfonamides, Streptomycin, Levomycetin, tetracyclines);
• protein and polypeptide preparations (vaccines and toxoids, enzyme and hormonal agents, plasma preparations and plasma-substituting solutions);
• some aromatic amines (Hypothiazide, para-aminosalicylic acid, para-aminobenzoic acid, a number of dyes);
• non-steroidal anti-inflammatory drugs (NSAIDs);
• anesthetics (Novocaine, Lidocaine, Trimecaine, etc.);
• radiopaque substances;
• preparations containing iodine;
• vitamins (mostly of group B).

The second place in the ability to cause anaphylaxis is occupied by the bites of hymenoptera insects (about 40%).

The third group is food (approximately 10% of cases):

• fish, canned fish, caviar;
• crustaceans;
• cow's milk;
• egg white;
• legumes;
• nuts;
• food additives (sulfites, antioxidants, preservatives, etc.).

The incidence of anaphylactic shock in the Russian Federation is 1 per 70,000 population per year.

The main provocateurs also include medicinal allergens, physical factors and latex products.

Factors that increase the severity of anaphylaxis:

• bronchial asthma;
• diseases of the cardiovascular system;
• therapy with beta-blockers, MAO inhibitors, ACE inhibitors;
• allergy vaccination (specific immunotherapy).

Forms

Anaphylactic shock is classified depending on the clinical manifestations and the nature of the pathological process.

In accordance with the clinical symptoms, the following variants are distinguished:

• typical (mild, moderate and severe);
• hemodynamic (manifestations of circulatory disorders prevail);
• asphyxia (symptoms of acute respiratory failure come to the fore);
• cerebral (neurological manifestations are leading);
• abdominal (symptoms of damage to the abdominal organs prevail);
• fulminant.

By the nature of the course, anaphylactic shock is:

• acute malignant;
• acute benign;
• protracted;
• recurrent;
• abortive.

The International Classification of Diseases of the 10th revision (ICD-10) offers a separate gradation:

• anaphylactic shock, unspecified;
• anaphylactic shock caused by a pathological reaction to food;
• anaphylactic shock associated with the administration of serum;
• anaphylactic shock caused by a pathological reaction to an adequately prescribed and correctly applied drug.

Stages

In the formation and course of anaphylaxis, there are 3 stages:

1. Immunological - changes in the immune system that occur when the allergen enters the body for the first time, the formation of antibodies and sensitization itself.
2. Pathochemical - release of mediators of an allergic reaction into the systemic circulation.
3. Pathophysiological - detailed clinical manifestations.

Symptoms

The time of the appearance of clinical signs of shock depends on the method of introducing the allergen into the body: with intravenous administration, the reaction can develop after 10-15 seconds, intramuscularly - after 1-2 minutes, oral - after 20-30 minutes.

The symptoms of anaphylaxis are very diverse, however, a number of leading symptoms are determined:

• hypotension, up to vascular collapse;
• bronchospasm;
• smooth muscle spasm gastrointestinal tract;
• stagnation of blood in both arterial and venous links of the circulatory system;
• increased permeability of the vascular wall.

Mild anaphylactic shock

The mild degree of typical anaphylactic shock is characterized by:

• itchy skin;
• headache, dizziness;
• feeling of heat, hot flashes, chills;
• sneezing and discharge of mucus from the nose;
• sore throat;
• bronchospasm with difficult exhalation;
• vomiting, cramping pain in the umbilical region;
• progressive weakness.

Anaphylactic shock is an immediate hypersensitivity reaction and is a life-threatening condition. A complete clinical picture of shock unfolds in a period from several seconds to 30 minutes.

Objectively, hyperemia (less often - cyanosis) of the skin, rash of varying severity, hoarseness of the voice, wheezing heard at a distance, a decrease in blood pressure (up to 60/30-50 / 0 mm Hg), a threadlike pulse and tachycardia up to 120– 150 bpm

Moderate anaphylactic shock

Symptoms of moderate anaphylactic shock:

• anxiety, fear of death;
• dizziness;
• heartache;
• diffuse pain in the abdominal cavity;
• indomitable vomiting;
• feeling short of breath, choking.

Objectively: consciousness is depressed, cold sticky sweat, pale skin, cyanotic nasolabial triangle, pupils dilated. Heart sounds are muffled, the pulse is threadlike, arrhythmic, rapid, blood pressure is not determined. Involuntary urination and defecation, tonic and clonic convulsions are possible, rarely bleeding of various localization.

Severe anaphylactic shock

The severe course of anaphylactic shock is characterized by:

• lightning-fast deployment of the clinic (from several seconds to several minutes);
• lack of consciousness.

There are marked cyanosis of the skin and visible mucous membranes, profuse sweat, persistent dilatation of the pupils, tonic-clonic convulsions, wheezing labored breathing with prolonged exhalation, frothy sputum. Heart sounds are not heard, blood pressure and pulsation of peripheral arteries are not detected. The victim, as a rule, does not have time to present complaints due to a sudden loss of consciousness; if you do not provide medical attention immediately, there is a high probability of death.

The severity of anaphylactic shock:

	Light flow	Medium severity	Heavy current
Arterial pressure	Decreases to 90/60 mm Hg. Art.	Decreases to 60/40 mm Hg. Art.	Not determined
Period of harbingers	10-15 minutes	2-5 minutes
Loss of consciousness	Short-term fainting	10-20 minutes	More than 30 minutes
Treatment effect	It responds well to treatment	The effect is delayed, long-term observation is required	No effect

When recovering from anaphylactic shock, the victims show weakness, lethargy, lethargy, severe chills, sometimes fever, muscle and joint pain, headache, stitching pains and discomfort in the heart.

Diagnostics

Diagnosis of anaphylactic shock is not difficult, since the connection of characteristic clinical manifestations with a previous insect bite, eating an allergenic product or using a drug is usually obvious.

Treatment

Shock treatment begins directly at the site of its occurrence, without waiting for the transportation of the victim to the specialized department. The outcome of the shock is decided by the timeliness and adequacy of first aid measures. The patient should be laid down with his legs raised, his head turned to one side.

Careful monitoring is essential. important indicators throughout the entire period of treatment and several hours after the relief of shock, since clinical symptoms can recur within a day.

In 50% of cases, anaphylactic shock is caused by medication.

Principles of therapy for anaphylactic shock:

• immediate cessation of the intake of the allergen (for example, removing an insect sting or stopping the administration of the drug);
• relief of acute respiratory and hemodynamic disorders;
• compensation for the developed adrenocortical insufficiency;
• neutralization of allergic mediators of anaphylaxis in the systemic circulation and antigen-antibody bonds;
• maintaining vital functions or carrying out resuscitation measures if necessary;
• normalization of acid-base balance;
• increased total peripheral vascular resistance;
• replenishment of the circulating blood volume.

Hospitalization in the intensive care unit and round-the-clock observation are indicated for patients with moderate or severe anaphylaxis, as well as those living far from medical institutions (since complex treatment continues for 72 hours).

After discharge, patients with anaphylaxis from insect bites are prescribed specific immunotherapy - a set of measures that reduce the body's sensitivity to the allergen by preventing the development or inhibition of sensitization (developing tolerance to the allergen by sequentially administering its microdoses in increasing concentrations).

Consequences and complications

Possible complications (can develop delayed, up to several weeks):

• allergic myocarditis;
• quincke's edema;
• recurrent urticaria;
• pulmonary edema;
• myocardial infarction;
• heart failure;
• the development of chronic allergic reactions;
• bronchial asthma;
• hepatitis;
• glomerulonephritis;
• "Shock kidney", "shock lung", "shock liver";
• bleeding of various localization;
• neuritis, diffuse lesion nervous system, vestibulopathy;
• epilepsy;
• autoimmune diseases.

Up to 40% of patients experience a recurrence of anaphylaxis within the next 2-3 years.

Forecast

With timely emergency care and adequate complex therapy, the prognosis is favorable. It worsens significantly at the beginning of anti-shock measures 30 or more minutes after the development of anaphylactic shock.

For the first time, anaphylactic shock is mentioned in documents dated 2641 BC. e. According to records, the Egyptian pharaoh Menes died from an insect bite.

Prevention

1. Avoid taking medications with a history of allergic reactions, or others that have cross-allergic activity with them.
2. Refrain from treatment with drugs that have a high risk of developing anaphylaxis, especially in patients with allergic diseases.
3. Avoid areas with a high probability of contact with insects.
4. Refuse perfume and cosmetics with an intense odor.
5. Allergy sufferers should have a diagnosis document with them.
6. When conducting an X-ray examination using a radio-opaque substance, the doctor must be warned about the existing allergic anamnesis.
7. Patients with a history of allergies are advised to give preference to oral forms of drugs.
8. All patients with anaphylactic shock should have an epinephrine emergency kit with them and know how to use it.

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Anaphylactic shock is an acute clinical manifestation of allergy. A person who encounters it needs urgent medical attention, otherwise there is a high risk of death.

Death ends in approximately 10% of all observed cases.

An acute allergic reaction is rare enough - about 50 cases for every 100 thousand people annually. What kind of disease, where does it come from and what are the health consequences?

Like any other allergy, anaphylactic shock (AS) occurs against the background of the production of antibodies to foreign substances.

In the overwhelming majority of cases, protein compounds become such substances.

Sometimes it can manifest itself as a cough, sneezing, or mild skin redness.

But in the situation under consideration, everything is much more serious.

When an allergy pathogen enters the body, histamine (basophils, eosinophils) is released from blood cells. This leads to a sharp, rapid drop in pressure, problems with the respiratory system and other adverse effects.

The main allergens are food and drugs. People who first eat exotic foods, sweets and some nuts, such as peanuts, are especially at risk.

Anaphylactic shock symptoms

Signs of the development of anaphylactic shock appear at different rates.

Sometimes the first symptoms appear several hours after ingestion of the allergen, but most often the manifestations become noticeable almost immediately - after a few minutes.

The symptoms of the disease are divided into two main types:

• local manifestations;
• common manifestations.

In the first case, the lesion affects only the areas that have direct contact with the allergen, for example, during injection. Common signs relate to the functionality of the whole organism as a whole, including those organs and systems that have not come into contact with the stimulus in any way.

The main local symptoms of anaphylactic shock:

• Redness of the skin, accompanied by edema. Most often it occurs after taking allergen medications, as well as as a result of eating the irritant. Edema sometimes takes on such proportions that it is impossible to recognize the person.
• Rash and itching. They develop only after consuming the allergen in food and getting it into the digestive tract. Most often appears in the area of \u200b\u200bthe ears, although there are other localizations, for example, in the area chest.
• Pain. It is localized at the site of contact with the allergen. Usually occurs after subcutaneous administration of medications. It is the first sign of impending anaphylactic shock, so you should pay special attention to increased pain sensations that do not go away for a long time after the injection.

The general symptoms of anaphylactic shock are more dangerous and can be fatal. These include:

• Chest pain. It occurs approximately 30 minutes after the ingestion of the allergen. It develops due to the administration of a medical drug, but in rare cases it manifests itself after eating certain foods.
• A sharp drop in blood pressure. It drops to 90 mm Hg. Art. and below.
• Nausea and vomiting. It is the body's natural attempt to rid itself of an allergen.
• Breathing disorder. Occurs due to laryngeal edema. Exhalation is especially difficult, which characterizes the phenomenon as “asthmatic edema”.
• Loss of consciousness. Directly associated with suffocation and falling blood pressure.

One of the earliest common symptoms of an acute allergic reaction is wheezing, accompanied by pale skin and bluish lips.

The clinical manifestations of anaphylactic shock develop very quickly. Delay can cost life, so at the first symptoms you need to call an "ambulance".

First aid for anaphylactic shock

Given that the clinical manifestations of anaphylactic shock develop very quickly, there is no time for preliminary diagnosis. Therefore, first aid should be provided immediately, after calling a medical team.

First aid is divided into two types:

• If the allergen is a medication injected under the skin, then a tourniquet must be applied above the injection site. This avoids further spread of the irritant.
• If the reaction is due to food product, you need to do an emergency gastric lavage. This is done with plenty of water to prevent further absorption of the allergen into the bloodstream.

Medical assistance provided by doctors includes:

• the introduction of 0.5 mg of a 1% solution of epinephrine (to increase pressure);
• injection of 1-2 mg of a 1% solution of an antihistamine drug (diphenhydramine, suprastin).

A 5% glucose solution is also injected.

It is possible to slightly raise the level of adrenaline by inflicting acute pain. There are cases when in restaurants of exotic cuisine allergy sufferers were brought back to life with the help of a slight blow with a fork inflicted on the buttock.

Consequences of anaphylactic shock

ASh does not leave without a trace - the blow to the body is too strong. After relief of the attack and restoration of pressure, the following often persist:

• weakness, lethargy and slight lethargy;
• painful sensations in the joints and muscles;
• chills accompanied by fever;
• vomiting and nausea;
• heart pain (relieved with nitroglycerin and riboxin);
• prolonged decrease in blood pressure (eliminated with the help of adrenaline and dopamine);
• headaches and a temporary decrease in intelligence are the consequences of hypoxia due to low blood pressure.

These symptoms disappear over time. But some of the consequences persist for a long time:

• quincke's edema;
• bronchial asthma;
• hives;
• neuritis;
• diffuse damage to the nervous system (often ends in death).

Repeated exposure to the allergen may result in lupus.

Prevention of an acute allergic reaction

The main way to avoid AS is to exclude contact with allergens. In addition, it is recommended:

• limit bad habits (use of tobacco and alcohol);
• buy medicines only from licensed pharmacies;
• try not to eat foods with added glutamate.

One of the controversial methods of prevention is to ask the doctor not to prescribe a large number of drugs at the same time for the treatment of any disease.

Recurrence of the disease avoids:

• regular ventilation of the room to remove particles from the home or office that can cause a negative reaction;
• wearing safety glasses and masks during flowering plants;
• refusal to use upholstered furniture and toys (it is recommended only in cases where the source of the allergy is accurately identified, otherwise it is pointless to give up comfort);
• constant wet cleaning of premises (as well as ventilation, this measure removes small particles that can provoke AS).

When introducing new drugs, the doctor must check the body for sensitivity to allergens. Feel free to remind him of this.

Anaphylactic shock is a dangerous phenomenon that can lead to serious health problems and sometimes death.

First aid is to limit the spread of the allergen: a tourniquet above the injection site, gastric lavage. The arriving doctors will try to raise the pressure by injecting adrenaline. The main principle of AS prevention is to limit contact with allergens. Regular wet cleaning, control over the quality of food consumed, as well as compliance with the rules of personal hygiene help a lot.

Video on the topic

Anaphylactic shock begins very quickly and suddenly. It affects the body very hard, and its consequences can sometimes be unpredictable, but they are also quite severe. The consequences of this condition do not depend on what exactly caused the shock. This phenomenon can occur for each person according to an individual scenario.

Some researchers have considered descriptions of five hundred manifestations of anaphylactic shock, provoked by completely different reasons. But among all five hundred, there were no two episodes identical in terms of symptoms, complexity and outcome.

The consequences of this phenomenon are all the more destructive, the shorter the period between the introduction of the allergen into the body and the appearance of the first signs of anaphylactic shock. Immediately after the attack, the patient does not experience allergy symptoms for some time. But if after some time a person has this condition again, then it will be much more difficult.

This condition can be a trigger for the development of serious diseases such as non-infectious

jaundice, agglomerulonephritis

Various malfunctions of the central nervous system, vestibular apparatus, myocardium and many others.

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• respiratory;
• circulatory;
• heart;
• skin;
• brain;
• mucous membranes.

Anaphylactic shock symptoms
Classification	The form	Symptoms
Localization	Typical	Skin swelling, difficulty breathing, disruption of the circulatory system.
	Asphytic	Spasm of the respiratory tract, edema of the larynx and other respiratory organs, asphyxia.
	Cerebral	Damage to the central nervous system, up to cerebral edema (behavioral disturbances, irritability, fatigue).
	Abdominal	On the part of the digestive tract, there are all signs of poisoning (pain, vomiting, stool disorder, nausea, flatulence, heartburn, belching, weakness, irritability).
	Hemodynamic	Disruption of the cardiovascular system (chest pain of a different nature and severity, interruptions in the work of the heart, shortness of breath, edema, discoloration of the skin, headaches and dizziness).
Severity	1 type	The pressure is below normal (systolic 110/120 and diastolic 70/90) by 30-40 units. The victim is conscious, but is in a state of panic, there is a fear of death. Anti-shock drug treatment is successful on the first try.
	Type 2	The pressure is below normal (systolic 110/120 and diastolic 70/90) by 40-60 units. There is a possibility of loss of consciousness, which is confused. Numbness. The response to anti-shock therapy is good.
	Type 3	The pressure is below normal and cannot be determined by a meter (systolic 110/120 and diastolic 70/90) at 60-80 units. The victim is on the verge of losing consciousness. Very weak response to anti-shock therapy.
	4 type	Cannot determine pressure. The victim is unconscious. There is no reaction to anti-shock drug therapy.
Speed	Malignant acute	A sudden and significant drop in pressure, bronchospasm, respiratory failure, confused consciousness, pulmonary edema, skin rashes, coma and death are possible.
	Benign acute	Manifestations from various body systems reach their peak (respiratory failure, skin manifestations, gastrointestinal upset, central nervous system disorders) and gradually subside in response to timely anti-shock treatment.
	Abortive	Very weak manifestations, mainly from the respiratory system. Symptoms often resolve without the use of medication.
	Protracted	All the symptoms of typical anaphylactic shock appear, but the response to treatment is weak. A relapse occurs with a sharp drop in pressure and other signs of anaphylaxis.
	Lightning fast	Symptoms appear within a few seconds (up to half a minute) and the condition worsens too quickly for therapy to succeed. There is a chance to survive only when adrenaline and other medications are administered almost simultaneously with the allergen.

Ambulance type	Algorithm of actions
First aid	1. Ensuring normal blood flow (especially to the heart). To do this, the victim is placed on a flat surface, and the legs are raised above the level of the body, using a roller made of clothes or other objects. 3. Calling an ambulance.
Health care	1. The introduction of an adrenaline solution in a different way, depending on the severity of the patient's condition. Injection of the injection or bite site with an adrenaline solution (0.1% for 4-6 points in a circle).

What kind ?

• disturbances in the work of the central nervous system;
• bleeding in the digestive tract;
• spasms of the bronchi;
• pulmonary edema;
• swelling of the brain;
• cerebral hemorrhage;
• to whom.

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Consequences of anaphylactic shock

Anaphylactic shock or, in other words, anaphylaxis is a very serious manifestation of an allergic reaction that is characterized by a fulminant course and can be fatal. If a person suddenly became ill, how to understand - is it anaphylaxis or not? How to provide first aid for anaphylactic shock? Read about this and much more below.

Recognizing anaphylactic shock is not easy due to the polymorphism of this reaction. In each individual case, the signs are varied and are closely related to the "attacked" organ.

In total, there are three forms of anaphylactic shock:

1. Lightning fast... Often, the patient does not even have time to realize what is happening to him. After the allergen enters the bloodstream, the disease develops very rapidly (1-2 minutes). The first symptoms are a sharp blanching of the skin and shortness of breath, signs of clinical death are possible. Soon, acute cardiovascular failure develops and, as a result, death.
2. Heavy... 5-10 minutes after the allergen enters the bloodstream, signs of anaphylactic shock begin to appear. The person does not have enough air, pains in the heart appear. Failure to provide the necessary assistance immediately after the onset of the first symptoms can be fatal.
3. Average... 30 minutes after the allergen enters the bloodstream, the patient begins to develop fever, headache, and discomfort in the chest area. Death is possible in rare cases.

Possible manifestations of anaphylaxis include:

1. Dermal - urticaria, redness, irritation, rash, Quincke's edema.
2. Respiratory - shortness of breath, noisy breathing, swelling of the upper respiratory tract, asthma attack, severe itching in the nose, sudden runny nose.
3. Cardiovascular - rapid heartbeat, a feeling that it "turned over", "bursting out of the chest", loss of consciousness, severe pain behind the breastbone.
4. Gastrointestinal - heaviness in the stomach, nausea, vomiting, bloody stools, cramps.
5. Neurological - convulsive syndrome, agitation, anxiety, panic.

Anaphylactic shock can have various causes. Most often, anaphylaxis of allergic genesis occurs. But there is also a non-allergic option. What happens in the body in shock?

In the case of allergic anaphylaxis, the "foreign" protein, entering the body, entails the release of a huge amount of histamine, which, in turn, greatly expands the vessels, causing edema, as well as a sharp decrease in blood pressure.

In the case of non-allergic anaphylaxis, histamine release can be caused by various drugs that act on the so-called "mast cells" and provoke the same symptoms.

Most often, reactions occur at the level of the skin and mucous membranes. Manifestations are visualized soon after contact with the cause of the shock (within a few minutes).

Most often, the causes of anaphylactic shock of allergic genesis are:

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Consequences of anaphylactic shock

Unfortunately, anaphylaxis affects the entire body. In some cases, the shock can pass without consequences, and in others, the stress experienced makes itself felt throughout life.

The worst consequence can be death. In order to prevent it, at the first symptoms of anaphylaxis, call an ambulance.

Cut off contact of the patient with the allergen, if possible. For example, if it's an insect bite, remove the sting and apply cold. Next, open the window, provide fresh air to the room. Lay the victim on their side. If there is an antihistamine at home and you can get an injection, take action. If not, then wait for the doctors. In such cases, the team arrives very quickly.

Patients who are aware of their propensity for anaphylactic shock should always carry a dose of epinephrine (sold in the west as an Epi-pen) with them. It must be injected into any part of the body at the first sign of anaphylaxis. Epinephrine supports body functions until the arrival of doctors and saves thousands of lives every year.

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The most severe and dangerous manifestation of allergic reactions is anaphylactic shock, which is fatal in 10% of cases.

The frequency of this condition varies within 50 cases per 100 thousand population, in last years there is a tendency towards an increase in the incidence of anaphylactic shock, which is associated with the frequent development of food allergies and pollution environment... Men and women are equally at risk of this allergic reaction.

The mechanism of development of anaphylactic shock, like any allergic reaction, consists in the formation of antibodies to a foreign substance entering the body. These substances are more often protein compounds called allergens.

An allergic reaction develops when the allergen re-enters the body, while antibodies are produced, histamine is released from the blood cells of eosinophils and basophils, which acts on the vascular wall of the arteries, causing a decrease in systemic blood pressure.

The causes of anaphylactic shock are food allergens (chocolate, peanuts), household chemicals, medicines (penicillin antibiotics, novocaine). Due to its rapid development, anaphylactic shock refers to an immediate-type hypersensitivity reaction.

Anaphylactic shock is characterized by the rapid development of a severe reaction within a few hours from the moment the allergen enters the body. The symptoms of anaphylaxis can be conditionally divided into local and general manifestations.

Local symptoms include:

• pain or itching at the place where the allergen enters the body - it happens after injection intramuscular or subcutaneous administration of drugs or vaccines, this is the first symptom that should be alarming for allergies;

• redness and swelling of the skin - also occurs at the injection site of the allergen, develops quickly, within a few minutes, edema can be pronounced, with food allergies, pronounced swelling of the facial skin develops, which makes the patient unrecognizable;

• rash - develops with food allergies after the allergen enters the gastrointestinal tract, the favorite localization of the rash is the skin of the face, it may be accompanied by itching.

Common symptoms include:

• violation of respiratory functions - due to spasm of the larynx and bronchioles, breathing worsens, and exhalation is more difficult ("asthmatic type"), breathing becomes noisy, wheezing appears, the skin becomes pale, and the lips become bluish;

• chest pain - appears within 10-30 minutes after intramuscular injection of a drug or vaccine;

• nausea and vomiting - develop with food allergies, as a protective reaction of the body to an allergen that has entered the stomach and intestines;

• decrease in systemic blood pressure - systolic blood pressure drops below 90 mm Hg. Art .;

• loss of consciousness - is the result of a decrease in systemic blood pressure.

It should be remembered that if there is anaphylactic shock, its clinic develops very quickly, rapidly. Therefore, when the first signs of this condition appear, you should immediately seek medical help.

Due to the rapid development of characteristic clinical symptoms, additional diagnosis of anaphylaxis is not carried out; treatment should be started immediately.

The determination of the substances that caused anaphylactic shock is carried out in a laboratory way after the removal of the acute symptoms of this condition.

Anaphylactic shock in children is difficult, with a pronounced decrease in blood pressure and respiratory failure. The principle of treatment is the same as in adults, only the dosages of medicines are calculated based on the age and weight of the child.

The consequences of anaphylactic shock can be different, most often they develop:

• myocarditis - inflammation of the heart muscle;

• polyneuropathy - toxic damage to the nerves;

• disruption of the central nervous system;

• glomerulonephritis - autoimmune kidney damage;

• bronchial asthma is a chronic allergic disease of the respiratory system, in which attacks of bronchospasm with shortness of breath develop.

Given the severe course, the large number of consequences and high mortality, the most important point is the prevention of anaphylactic shock. It includes measures to prevent the ingress of the allergen into the body:

• before the administration of a drug or vaccine, an intradermal test is performed for the presence of allergies, in case of a positive result of this test, another drug is selected;

• if a person has previously had allergic reactions to any food products, then they should be abandoned;

• in spring and summer, during active flowering of plants, walks in the fresh air should be limited, and prophylactic intake of antihistamines in tablets is also carried out - suprastin, loratadin, diazolin.

Any type of allergic reaction is a serious pathology that can lead to the development of anaphylactic shock, so all efforts should be directed to its prevention.

Anaphylaxis is the hardest reaction of the body to an allergen, which occurs unexpectedly and develops almost at lightning speed. In 99.9% of cases, the life of the victim depends on the actions that others will take.

In comparison with the usual negative reaction of the body to the allergen, anaphylaxis is characterized by a tenfold increase in the rate of pathological changes in the victim's body, as well as their severity. Almost all vital systems are affected:

Anaphylactic shock is especially dangerous for children in whom all systems of the body are not yet sufficiently developed, as well as due to the narrowness of the respiratory lumen.

The table below discusses the features of the symptoms of anaphylaxis, depending on the exposure to the allergen.

Anaphylactic shock is an allergic reaction in which providing assistance in the first minutes of the manifestation of negative symptoms can help the patient survive.

Emergency care for anaphylaxis is divided into pre-medical and medical (a table with the main algorithm of actions is presented below).

2. Providing oxygen supply and stopping the action of the allergen. To do this, open all the windows in the room where the patient is, unbutton his clothes.

4. Checking the victim's mouth for misaligned dentures that interfere with breathing. If he has a retraction of the tongue, then you need to place a solid object between the teeth, and turn his head to the left or right.

5. If the allergen got into the patient's blood through an injection or an insect bite, then the place above the affected area must be pulled with a tourniquet. Apply ice to the manipulation area.

6. Tell the ambulance doctors about all actions taken and symptoms observed.

2. Intravenous or jet injection of one of the following drugs: prednisolone, hydrocortisone or dexamethasone.

3. Introducing a large volume of sodium chloride into the patient's body (depending on the patient's weight).

4. Inhalation of oxygen to the patient through a special mask. If necessary, a tracheotomy is performed.

5. Introduction of antihistamines (with caution).

6. Observation of the patient in the hospital for a week to avoid relapse.

In addition to a possible relapse within 2-3 days, anaphylactic shock entails the following ailments:

• kidney disease (glomerulonephritis);
• bronchial asthma (chronic form);
• disturbances in the work of the central nervous system;
• toxic pathology of nerves (polyneuropathy);
• inflammation of the heart muscle (myocarditis);
• bleeding in the digestive tract;
• spasms of the bronchi;
• pulmonary edema;
• swelling of the brain;
• cerebral hemorrhage;
• to whom.

Anaphylaxis victim can be helped only in case of immediate medical attention. Healthy people with relatives with allergies of any type need to be prepared for this severe reaction and take preventive measures (attentiveness to food and medicines, caution during the seasonal flowering of some plants, etc.).

Quite often from doctors you can hear such a term as anaphylactic shock. For more than half of the population, it is not known what it is, and what symptoms and consequences it manifests. But anaphylactic shock is the most severe clinical manifestation of allergy, in which a person needs immediate help. In this article, we will tell you what symptoms indicate an attack, and what treatment needs to be provided in order to save a person's life.

An allergic reaction of an instantaneous course, which can develop both in a few hours and in a few seconds, if the allergen enters the human body again, is called anaphylactic shock. Mortality in the manifestation of pathology is 1% of all cases. When this reaction occurs to a drug, up to 20% of cases end in death.

This pathology does not have a specific age for manifestation. The pathogenesis of anaphylactic shock is quite complex.

A certain allergen comes into contact with immune cells, subsequently the latter produces special antibodies, which are called:

• immunoglobulins of the Ig G class;
• ig class immunoglobulins E.

Antibodies of these classes provoke a very large release of mediators of allergic reactions, which become provocateurs of the inflammatory process that spreads throughout all organs of the human body. Under the influence of inflammation, pathological changes occur: involuntary contraction of smooth muscles and blood vessels, increased blood clotting, bronchospasm, swelling occurs in different localization sites. This leads to a decrease in the volume of circulating blood and paralysis of the vasomotor centers, contributes to a decrease in blood pressure and inactivity of the heart muscles, up to cardiac arrest.

The disease can proceed in the following forms:

1. The most common is skin lesions with severe itching, redness, urticaria. There is also edema of the mucous membranes and subcutaneous fatty tissue (angioedema).
2. Less often, the nervous system suffers, a headache appears, sensitivity decreases, the feeling of nausea does not leave, epileptic seizures with loss of consciousness appear.
3. Anaphylactic shock flows into the cardiogenic zone (heart is affected), which leads to acute myocardial infarction.
4. The respiratory organs are affected, accompanied by the process of lack of oxygen, edema of the larynx, bronchi, followed by asphyxia.

Initially, we will figure out how the reaction of the human body to an irritant proceeds. At the first "acquaintance" with an allergenic substance that can cause anaphylactic shock, at the subsequent "meeting", the body does not show any symptoms, while it develops sensitivity, and also accumulates antibodies. Repeated contact with this substance provokes a violent attack of previously accumulated antibodies, which leads to an immediate reaction. The main factors that can provoke anaphylactic shock include the following groups of allergens:

1. Medicines. This includes antibiotics, serums, intravenous injections, iodine-containing drugs, hormones, etc. recent times quite often, seizures provoked by latex (medical rubber gloves) are recorded.
2. Food products. This group includes citruses, dairy products (casein), chocolate, red tomatoes, strawberries, eggs, and other food allergens.
3. Animals. The most common "provocateur" is the sting of bees, wasps, ticks, snakes. Less commonly, such a reaction can develop in domestic animals (wool, feathers).
4. Plants. The most common allergens include grass pollen, poplar fluff, and flower aromas during flowering.

To provoke anaphylactic shock, a portion of the allergen may be very small, in some cases a milligram of medicines or one spoonful of a dish containing an allergenic product is quite enough. But it should be remembered that the more "causative agent" of the reaction gets into the human body, the heavier and longer the shock will be.

Like any other disease, anaphylactic shock has its own symptoms. It depends on the course of the attack, which can be from mild (abortive) to extremely severe with a possible fatal outcome. If we talk about general symptoms, then in medicine it is customary to distinguish 3 periods of its development:

1. Period of seizure harbingers. The patient may feel weakness in the body, pain in the head, lack of air, blurred perception of the surrounding events by the organs of sight and hearing. Externally, rashes with severe itching, visible swelling of the skin and mucous membranes may appear.
2. The peak period. The patient loses consciousness, general hemodynamics is disturbed, pressure on the walls of arterial vessels decreases, tachycardia appears, breathing is noisy. Outwardly, the limbs and lips turn blue, the skin turns pale.
3. Exit (rehabilitation) period. After operative medical care for several more days, the patient feels general weakness, slight dizziness.

If the course of anaphylactic shock is mild, then the period of precursors of an attack lasts only about 15 minutes. During this time, the patient develops:

• hives;
• severe itching;
• there is a burning sensation throughout the body;
• swelling of the larynx, as a consequence of the hoarseness of the voice;
• quincke's edema.

During the period of the shock itself, the patient, before losing consciousness, can often experience unbearable pain in the head and chest, shortness of breath, numbness, hear noise or ringing in the ears, and fear of death appears. Bronchospasm with severe (loud) wheezing may occur. Breathing is difficult, the pulse is threadlike. Usually mild anaphylactic shock is accompanied by a gag reflex, loose stools, and involuntary urination.

Dilated pupils, numbness of the hands and lips are added to the precursors described for mild course. The attack itself is accompanied by tonic and clonic seizures (in certain cases they are absent), followed by fainting. During the examination, bradycardia, low pulse, muffled tones in the heart are recorded. In some cases of the development of the disease, the patient has bleeding from the nose or in the abdominal cavity, in women, bleeding may be uterine.

With a severe course of pathology, shock develops rapidly, without a period of precursors, in the first few seconds after the onset of an attack, a person loses consciousness. If in the first minutes you do not provide him with medical first aid and do not stop the attack, then a sudden clinical death... The external manifestations of severe anaphylactic shock include severe pallor of the skin, the release of foamy saliva from the mouth, profuse sweating (large, visible drops), dilated pupils, convulsions. In such cases, the patient needs to be provided with an emergency ambulance and call a team of doctors.

The severity of the patient's condition with anaphylactic shock can be presented in the form of a table:

Anaphylactic shock is diagnosed mainly by clinical symptoms, since there is no time left for a complete examination, tests and allergological tests.

The main task of doctors in carrying out therapeutic actions is to eliminate disturbances in the work of the main vital organs and systems in the human body. Initially, contact with an allergenic substance that provokes an allergy is eliminated. This can be the abolition of the use of certain drugs, removal of the poison or sting of a wasp (bee).

As for drugs, sympathomimetics are administered firstly subcutaneously, then intravenously, by drip, until the person's condition improves. If the patient has a severe form of anaphylactic shock, then dopamine is injected into a vein. Also, when providing first aid, glucocorticoids are used, solutions are injected into the bloodstream to correct the density of blood, its volume in the body, and increase pressure.

Once the condition has stabilized, treatment of symptoms continues. For this, antihistamines, bronchodilators, diuretics are widely used.

Inpatient treatment usually lasts up to 10 days. If there are no complications, then the patient is discharged, but he must undergo constant monitoring to identify symptoms of possible complications.

Anaphylactic shock "gives a failure" to the whole body, so it cannot pass without a trace. After stopping the development of pathology and normalizing the functioning of the heart and respiratory system, the patient may have general symptoms. After 10, maximum 15 days, a relapse may develop with Quincke's edema, urticaria. It is also possible manifestation of bronchial asthma. If contact with the allergen continues, then lupus and periarteritis nodosa may well appear.

With the development of complications, a person can acquire the following diseases, such as:

• hepatitis of a different group;
• damage to the central nervous system;
• myocarditis (allergic);
• vestibulopathy.

These diseases are subsequently the cause of death of the patient.

With timely medical measures, a complete recovery from anaphylactic shock is quite possible. The timing of the patient's withdrawal from this state can last from hours to days.

Anaphylactic shock (anaphylaxis) is a highly sensitive state of the body. It can occur as a result of repeated introduction into the body of foreign proteins, medicines, in case of errors in blood transfusion, even with the bite of some insects. Anaphylactic shock is one of the most dangerous complications of drug allergy. In about 10-20% of cases, anaphylactic shock is fatal.

Anaphylactic shock is accompanied by difficulty breathing, a decrease in blood pressure, etc. There are several degrees of anaphylactic shock: mild, moderate, severe and extremely severe. Also, anaphylactic shock can lead to predominant damage to some organs or organ system.

Anaphylactic shock often develops with lightning speed, so it is almost impossible to predict it. However, it is possible to trace allergic reactions to a particular substance and in the future to avoid its entry into the body. Anaphylactic shock is sometimes preceded by some specific symptoms, that is, we can talk about the possible presence of a prodromal period.

Even an insect bite can cause anaphylactic shock. Of course, not every person has. To understand what it is - anaphylactic shock, you can give a simple example. Probably, every person has been bitten by a bee or a wasp at least once in his life - an unpleasant, but not dangerous feeling. Not dangerous for most, but not absolutely for everyone. Some people, after a seemingly harmless bite, begin to choke and may even faint. The thing is that the human body reacts very inadequately to such a bite - this is anaphylactic shock.

One of the most sensitive signs of anaphylaxis is decreased blood flow. The blood flow begins to decrease sharply (therefore, anaphylactic shock can develop with lightning speed). First, the peripheral circulation is disturbed, and then the central one. This happens under the influence of histamine and other mediators, which are produced in large quantities by the cells of the body. Due to a decrease in blood flow, the skin becomes pale. The skin is cold and damp to the touch. Also, due to circulatory disorders, there is anxiety in the brain and other organs. This situation is characterized by clouding of consciousness (up to its loss, since the brain and other organs do not receive enough oxygen due to circulatory disorders), breathing problems (shortness of breath). Urination is often impaired.

A harbinger of anaphylaxis is a local reaction where the allergen enters the human body. And this is not even so much a harbinger of anaphylactic shock as its first symptom. The local reaction is pronounced. It can be very severe pain, swelling in the place that was bitten by an insect or where an injection of the drug was made. Severe itching of the skin is often noted. If the allergen gets inside the body, then anaphylactic shock begins with a sharp pain in the abdomen. In this case, the patient has nausea, vomiting. That is, in this case, we can talk about symptoms of dysfunction of the gastrointestinal tract (gastrointestinal tract). The oral cavity and larynx are swollen.

Anaphylactic shock is characterized by difficulty breathing. Difficulty breathing is caused by laryngeal edema, bronchospasm. "Asthmatic" breathing, that is, hoarse, rapid, noisy, always accompanies the development of anaphylactic shock. In addition to difficulty breathing, anaphylaxis is characterized by pale skin and bluish lips, fingers, visible mucous membranes, and a drop in blood pressure.

In some patients in a state of anaphylactic shock, convulsions are observed, foam may appear from the mouth, urination and defecation may occur involuntarily, and bloody discharge from the vagina is also possible. All this creates a life-threatening situation for the patient.

Death can occur within minutes or hours after the onset of anaphylactic shock, that is, after the allergen enters the body. If the patient loses consciousness, he may die from suffocation in the first 5-30 minutes after the allergen enters his body. If there are severe and irreversible changes in organs that are vital, then death may occur one or two days after the onset of anaphylactic shock.

If, as a result of anaphylaxis, changes occur in the heart, in the brain (for example, cerebral edema or hemorrhage in the brain), in the gastrointestinal tract (for example, intestinal bleeding), in the kidneys, then a person may die after a much longer period of time compared to the cases described above.

In addition, the state of anaphylactic shock is characterized by a situation in which, some time after the improvement of the general condition of the patient, a sharp decrease in blood pressure can again be observed. As a result of all of the above, those persons who have suffered a state of anaphylaxis should be monitored in a hospital for at least two weeks.

There are several degrees of severity of anaphylactic shock. There are four of them.

The first degree is easy. Anaphylactic shock lasts from several minutes to two hours. In this case, it is characterized by the presence of itching of the skin, hyperemia of the skin (that is, increased blood circulation in a tissue or organ - in this case, tissue). The patient has a headache, dizziness, fever, tachycardia, discomfort in the body, a feeling of tightness in the chest, shortness of breath and increasing weakness.

The second degree is moderate. For anaphylactic shock in this case, a more detailed clinical picture is characteristic, compared with a mild degree. It is represented by Quincke's edema (this is an acute allergic reaction, which is associated with rashes in the human body, accompanied by tissue edema), increased heart rate, arrhythmias, pain in the heart, and a decrease in blood pressure. The patient often has conjunctivitis and stomatitis. The patient may experience feelings of excitement, anxiety, and fear. He may have decreased hearing and a noise in his head. All this is accompanied by severe weakness. Many people have kidney syndrome, such as urinary frequency, and gastrointestinal syndrome. The latter can include bloating and severe abdominal pain, nausea and vomiting, etc.

The third degree is severe. Anaphylaxis in this case is associated with the development of acute cardiovascular and respiratory failure. This can be a sharp drop in blood pressure, shortness of breath, stridor breathing. The latter is a high-pitched sound that occurs due to the exhalation of air or its inhalation through a narrowed breathing tube - such a narrowing can occur as a result of inflammation of the bronchial mucosa. Very often, severe anaphylactic shock is accompanied by loss of consciousness.

The fourth degree is extremely difficult. Anaphylactic shock leads to the instantaneous development of collapse. Collapse is a condition of the body that is associated with a sharp decrease in blood pressure, a sharp drop in vascular tone, deterioration of blood circulation, as a result of which vital organs suffer (for example, the flow of venous blood to the heart is significantly reduced, arterial and venous pressure decreases, and brain hypoxia). The state of collapse threatens the patient's life. Also, anaphylaxis in this case can lead to the occurrence coma, which is associated with the rapid loss of consciousness of the patient. In this case, urination and defecation occur involuntarily.

For the fourth degree of anaphylactic shock, the following symptoms are also characteristic: dilated pupils, lack of their response to light. If blood pressure continues to fall, then the pulse becomes undetectable. Cardiac arrest and cessation of breathing are possible.

Anaphylactic shock can damage individual organs or systems. In this case, the defeat does not extend to the entire organism, but mainly to some part of it. Such options for anaphylactic shock include the following.

Anaphylactic shock with a predominant lesion of the skin is characterized by the presence of Quincke's edema, urticaria and severe pruritus, which tends to grow.

Anaphylactic shock with a predominant lesion of the nervous system is determined by the presence of a severe headache in the patient. Characteristic feature also the presence of nausea and the appearance of seizures, accompanied by involuntary bowel movements and urination. The patient often loses consciousness.

Anaphylactic shock with a predominant lesion of the respiratory system is associated with the patient's suffocation. In this case, they talk about the asthmatic variant of anaphylaxis. The patient develops asphyxia (that is, a critical state of the body, which is characterized by the accumulation of carbon dioxide due to a lack of oxygen in the body). The reason is the obstruction of the upper respiratory tract. This is due to edema of the larynx, as well as a violation of the normal patency of the middle and small bronchi.

Anaphylactic shock with predominant heart damage is characterized by the development of myocardial infarction or acute myocarditis. In this case, they speak of cardiogenic anaphylaxis.

Anaphylactic shock is characterized by a period of resistance. This period lasts for the first two or three weeks after anaphylaxis. The period is characterized by the gradual disappearance of allergy manifestations. A patient who has suffered anaphylactic shock must be extremely careful. In order to prevent re-entry of the allergen into the body, due to which anaphylactic shock developed. The reason for this is that with repeated ingestion of such an allergen, the course of anaphylaxis is more severe. This also applies to those cases when a fairly long period of time (months and years) has passed after anaphylactic shock.

Anaphylactic shock can cause many complications. These include the development of myocarditis (that is, allergic lesions of the heart muscle), hepatitis (allergic liver damage), glomerulonephritis (allergic kidney damage), as well as various lesions of the nervous system, etc. Possible complications of anaphylactic shock include exacerbation of existing chronic diseases.

In anaphylactic shock, confusion should not be allowed. This means that medical care for a patient in a state of anaphylaxis should be provided extremely quickly and clearly. The correct sequence of actions must be followed. First, it is immediately required to stop the effect of the allergen on the patient's body. If the state of anaphylactic shock has developed as a result of the introduction of a drug into the body, then it is necessary to suspend its introduction. If the cause of anaphylactic shock is an insect bite (for example, a bee), then it is necessary to immediately (but, nevertheless, very carefully) remove the sting from the place with the poisonous sac.

If there is an objectively determined possibility, then it is recommended to apply a tourniquet above the site of the bite or injection of the drug, and then, in order to prevent the spread of the allergen throughout the body, this place should be injected with an adrenaline solution. This will help create a local spasm of the blood vessels.

After the above actions, the patient should be helped to accept a position in which the likelihood of tongue sinking is minimal. In this case, the penetration of vomit into the respiratory tract will also be prevented. A patient in a state of anaphylactic shock must provide fresh air to the body. An oxygen bag can be used. All this refers to the first measures on which the success of further treatment largely depends.

Further treatment of anaphylaxis is carried out in order to neutralize biologically active substances, normalize the general condition of the patient. As a result of appropriate treatment, the respiratory and cardiovascular activity of the body is normalized. It is important to prevent the development of complications after anaphylactic shock.

Anaphylactic shock is predictable. In most cases, this is far from the case. The state of anaphylaxis cannot be predicted. However, it is quite realistic for every person to pay close attention to how the body reacts to certain foods, to a particular substance, to insect bites, etc. If allergic reactions are noted, then it is necessary to strictly beware of their re-entry into the body. After all, it is precisely a second hit that can lead to a state of anaphylactic shock. Thus, it can be concluded that the prevention of anaphylactic shock largely depends on a thoroughly collected allergic history.

Observations and studies have shown that anaphylactic shock develops only (!) As a result of repeated exposure to the allergen on the body. If the patient has not previously been exposed to an allergen, then he is out of danger of developing anaphylactic shock.

Also, science knows that the state of anaphylaxis is usually preceded by allergic reactions that do not lead to it. Those people who have suffered a state of anaphylactic shock should always have a card on which the allergen leading to anaphylaxis is indicated. You must have a special anaphylactic kit, which will be used if necessary. All this, of course, should always be with you (and not just at home in a secluded place).

The type of allergen does not affect the general clinical picture of the patient's condition. The allergen does not affect the severity of the state of anaphylaxis. As a result of the foregoing, it can be concluded that the clinical picture of anaphylaxis is diverse, this can be judged on the basis of the following data: when comparing five hundred cases of anaphylactic shock, each of which was caused by different allergens, not even two cases were recorded, such that the clinical picture coincided. Each case of the development of anaphylaxis had its own set of symptoms, differed from others in the severity of the course, could have prodromal (that is, previous) phenomena, or might not have.

Anaphylactic shock is characterized by the presence of a prodromal period. To be more precise, it should be said that the state of anaphylaxis may be preceded by a prodromal period, but it may not be. In the latter case, anaphylactic shock develops instantly and leads to collapse - the patient loses consciousness. This condition is characterized by the presence of seizures. Often a person dies.

The opinion of some authors investigating the problem of anaphylactic shock is that some of the elderly who die, seemingly from cardiovascular insufficiency, actually die from anaphylactic shock as a result of, for example, an insect bite. In this case, timely medical assistance often cannot be provided.

If the prodromal period does occur, then its duration varies from only a few seconds to an hour. The prodromal period is usually associated with the appearance in the patient of a feeling of heat, excitement or weakness and depression, chest pain, which can be characterized as constrictive, headache and some other phenomena. Quite often (but still not always) in the prodromal period the following phenomena occur: itching of the skin, lacrimation, perspiration and cough (dry). A rash may appear on the skin, swelling is likely. The prodromal period ends with the appearance of symptoms that outline the actual picture of anaphylactic shock.