ANAPHYLACTIC REACTION ANAPHYLACTIC SHOCK DEFINED Acute systemic hypersensitivity

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ANAPHYLACTIC REACTION

ANAPHYLACTIC REACTION

ANAPHYLACTIC SHOCK • DEFINED: Acute systemic hypersensitivity reaction that occurs within seconds to minutes

ANAPHYLACTIC SHOCK • DEFINED: Acute systemic hypersensitivity reaction that occurs within seconds to minutes after exposure to a variety of foreign substances • SUCH AS: medications (penicillin, IVP dye), stinging insects • CAUSED BY: an antigen antibody response

Clinical manifestations • Wide range of clinical manifestations

Clinical manifestations • Wide range of clinical manifestations

SKIN MANIFESTATIONS • flushing, • sense of warmth, • diffuse erythema, • generalized itching,

SKIN MANIFESTATIONS • flushing, • sense of warmth, • diffuse erythema, • generalized itching, • uriticaria (hives), • facial angioedema • leading to respiratory edema

RESPIRATORY SIGNS • • nasal congestion, itching, sneezing, coughing, bronchospasm, edema of the larynx,

RESPIRATORY SIGNS • • nasal congestion, itching, sneezing, coughing, bronchospasm, edema of the larynx, tightness of the chest, wheezing, dyspnea, cyanosis

CARDIOVASCULAR • Tachycardia • Bradycardia • PERIPHERAL VASCULAR COLLAPSE: pallor, imperceptible pulse, decreasing BP,

CARDIOVASCULAR • Tachycardia • Bradycardia • PERIPHERAL VASCULAR COLLAPSE: pallor, imperceptible pulse, decreasing BP, circulatory failure leading to coma, death

PREVENTION • Determine what patient allergic too through sensitivity testing via allergist • Wear

PREVENTION • Determine what patient allergic too through sensitivity testing via allergist • Wear medic alert bracelet • Carry epi-pen, check expiration date

GASTROINTESTINAL • Nausea, vomiting, colicky abdominal pains or diarrhea

GASTROINTESTINAL • Nausea, vomiting, colicky abdominal pains or diarrhea

NURSING DIAGNOSIS • Decreased cardiac output • Impaired gas exchange • Risk for fluid

NURSING DIAGNOSIS • Decreased cardiac output • Impaired gas exchange • Risk for fluid volume deficit • Anxiety

EMERGENCY MANAGEMENT • Establish an airway while another person gives epinephrine; administer oxygen •

EMERGENCY MANAGEMENT • Establish an airway while another person gives epinephrine; administer oxygen • Epinephrine SQ or IV provides rapid relief of hypersensitivity reaction and may be repeated • EPINEPHRINE: given to restore vascular tone and raise arterial BP; vasoconstricts • DOSE: 1: 1000 sol (0. 3 ml SQ q 5 -15 min)

EMERGENCY TX CONTINUED • Remove the antigen (blood, penicillin IV, or other antibiotic) •

EMERGENCY TX CONTINUED • Remove the antigen (blood, penicillin IV, or other antibiotic) • Benadryl IV push – antihistamine effect, reverses histamine effects (vaso-dilation and bronchoconstriction) • Solu-Medrol IVPB as an antiinflammatory • Pepcid IVPB to prevent gastric irritation from steroids

EMERGENCY TX CONTINUED • Check if patient is on beta-adrenergic blocking drugs such as

EMERGENCY TX CONTINUED • Check if patient is on beta-adrenergic blocking drugs such as Inderal; • These drugs decrease the effectiveness of the epinephrine • Patient may have a recurrence of symptoms 6 -8 hours after initial anaphylactic reaction

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