Anaphylactic Shock - Causes, Symptoms, Prevention and Remedies

Anaphylactic shock - this is one of the most dangerous types of the course of an allergic reaction. It can develop in response to contact with any allergen, it all depends on individual predisposition. An anaphylactic shock (anaphylaxis) is a severe allergic shock. It can be triggered, for example, by insect venom (from bees, wasps, etc.), foodstuffs (peanuts, celery etc.) or remedies (such as antibiotics). In the worst case, respiratory and cardio-vascular arrest occur. An anaphylactic shock must, therefore, be immediately treated by a doctor!

Anaphylactic shock develops in time from a few seconds to a few hours after contact with an allergen in the body. It depends on many factors, including the mode of administration of the allergen, but it is generally accepted view is that the faster developing an allergic reaction, so it is more difficult and the worse the prognosis for recovery, especially in the untimely assistance.

Anaphylactic shock: Details

The term anaphylactic shock refers to the severest form of an allergic reaction of the immediate type. This means that the symptoms develop within a very short time after contact with the allergen (allergen).

Anaphylactic shock: What happens in the body

On the first contact with a potential allergen, the organism forms specific antibodies against it. On the next contact, the immune system can react within a few minutes with a violent shock reaction (anaphylactic shock): the blood vessels in the arms and legs expand, and the wall of the vessels becomes more permeable. As a result, water flows out of the vessels into the interstices between individual cells and organs. Both together - the dilatation of the vessels and the liquid flow - let the blood pressure sag.
The body tries to counteract: messengers from the group of catecholamines (like adrenaline) are distributed. Among other things, they are supposed to drive the blood pressure back upwards by crowding the vessels. This is fatally prevented by other media (mediators) released upon contact between antigen and antibody (including histamine). In addition, the heart beat (tachycardia) is accelerated in the attempt to keep a sufficient blood flow and thus the oxygen supply of all body regions in motion.

Anaphylactic shock: Danger to life!

The described processes in the body trigger symptoms which can reach the entire body (skin, respiratory tract, cardiovascular system, digestive system) within a very short time and become life-threatening. Anaphylactic shock is, therefore, an emergency and requires immediate medical assistance!

Anaphylactic shock: Symptoms

Depending on the severity of the symptoms, medical professionals differ in four severity levels of anaphylaxis:
  • Severity: An allergic shock in its simplest form is associated with slight general reactions ( dizziness, headache, etc.) and skin reactions ( itching, reddening with heat, nettle, etc.). There is no acute danger to life, but the further course must be carefully monitored.
  • Severity: If there is a blood pressure drop, accelerated heartbeat (tachycardia), mild dyspnea, and gastrointestinal symptoms (such as nausea, vomiting), there is an allergic shock of the second degree.
  • Severity: the Anaphylactic shock of the third degree is characterized by the fact that, in addition to the above-mentioned symptoms, spasm of the respiratory tract (bronchospasm) and shock occur. Rarely, there is also a laryngeal swelling (Quincke edema) with air scarring.
  • Severity: In extreme cases, anaphylactic shock leads to the respiratory and cardiac arrest.

Anaphylactic shock: Causes and risk factors

The cause of anaphylactic shock is an immune reaction of the body. Anaphylactic shock is an allergic reaction. Contact with a specific substance (allergen) causes sensitization in the body. 

This means that the allergen, which is actually harmless to the body (for example, peanuts) is suddenly seen as a threat and is countered by the immune reaction. 

Normally the immune reaction takes place in pathogens such as viruses, bacteria or fungi, which are actually a threat to the body and are therefore combated. The actually harmless stimuli of the allergens are countered by an often violent immune reaction of the body. 

Anaphylactic shock can be caused by various allergy triggers (allergens), for example by:
Medicines (such as painkillers, antibiotics, iodine-containing x-ray contrast agents)
  • Insects (eg bees, wasps, bumble bees)
  • Foodstuffs (such as peanuts, walnuts, milk, soya, shellfish, fish)
  • cosmetics
  • Naturlatex (eg in rubber gloves and balloons)

Anaphylactic shock: Diagnosis

An allergy which can cause a life-threatening anaphylactic shock can be found in various ways because it can sometimes be very difficult to determine the true cause of an allergy. 

Firstly, the history of the patient (anamnesis) is an important factor. Those affected most often know best when and in what context allergic reactions have occurred. 

Various allergy tests (for example, skin and blood tests), which are carried out by the general practitioner or by specialists, can provide insight into the allergen. 

In anaphylactic shock, however, this possibility of diagnosis is not present. The severe physical reaction and possibly taken medicines distort the test results. This is why it is so important to see a doctor even at the slightest signs of an allergic reaction. 

However, some allergies occur particularly frequently and are therefore easier to determine. 

Foods such as peanuts, eggs or seafood, certain medicines ( penicillin, rheumatoid arthritis), insect pests, pollen, and insects often cause anaphylactic shock. If a parent is suffering from an allergy, it is also more likely to get it.

Anaphylactic shock: Treatment and therapy

Anaphylactic shock is treated individually. If the condition of the patient is acute, all first aid measures must first be initiated. This includes the elimination or elimination of the cause of the shock (allergens). 

For example, in a bee sting, the sting, should be removed as an allergy trigger as soon as possible. In addition, the affected person must immediately be placed in the so-called shock position. 

In this case, the patient has to lie on his back while the legs are placed upwards. In addition, the patient should be stored warm in order to avoid chilling. 

Regular pulmonary control is important to avoid circulatory shock. In a severe anaphylactic shock, a doctor will administer the remedy adrenaline, which causes the mucous membranes to decay and stabilize the circulatory system. 

Anaphylactic shock: What the doctor does

If it has not already been done, the alerted doctor will stop the intake of allergen, bring the patient into a shock and administer appropriate remedies to the symptoms of the shock (such as adrenaline). In addition, the patient receives oxygen as well as via an infusion a volume replacement solution to bring the "sagged" blood pressure up again. If an anaphylactic shock has triggered a laryngeal swelling with dyspnoea, the doctor can intubate (ie push a "breathing tube" into the air tube) or as a last measure to make an air tube section (emergency coniotomy). In case of cardiac arrest, the patient is resuscitated.

Anaphlylactic shock: Prevention

The best prevention against anaphylactic shock is its prevention. There should be no anaphylactic shock. This is why precaution is of such enormous importance. Already at the first signs of allergies, a doctor should be contacted immediately, who will carry out further examinations. 

If clarified, what causes the allergic reaction, this substance is to be avoided. This is, of course, very difficult with pollen or insect bites. However, there are different ways of desensitization. This is a special immunotherapy, in which the body slowly learns to no longer fight the allergen, but to tolerate it. 

Doctors also recommend an emergency kit. This should contain a so-called antihistamine. In an emergency, such a remedy will help to avoid an acute anaphylactic shock. However, tablets are not recommended for this because of the possibly occurring swallowing difficulties. 

Instead, an Asthma spray, a liquid remedy , or an adrenaline injector should be available. Whatever is best for whom should be agreed with the treating physician.

Anaphylactic shock: disease course and prognosis

Anaphylactic shock can already be noticed by symptoms shortly after contact with the allergen (allergen) by a person who is hypersensitive to intravenous remedies(syringe, infusion), can show the first signs of anaphylaxis within five minutes. In insect bites, anaphylactic shock occurs after about ten to fifteen minutes, and in foodstuffs about half an hour after exposure.

Even if patients with anaphylactic shock receive the right help quickly and the symptoms improve rapidly, monitoring in the intensive care unit is necessary for at least 24 hours.

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