Therapeutic procedure with anaphylactic reaction

Definition: The anaphylactic reaction is a system based allergic reaction that has a short course and is deadly.
The clinical syndromes are; multi organ affect including the skin, respiratory, gastrointestinal and cardiovascular systems.
Immune pathogenic mechanisms are based on the releasing of preformed mediators from the fat cells and basophiles, I.E. via a mediated reaction after a previous sensitization of the organism by drugs, foodstuffs, insect bite, vaccination and specific immunotherapy. The anaphylactic reaction has a clinically identical course; it only differs by the mechanism of degranulation of the fat cells and basophiles.

1. If it is possible, determine the anamnesis data of the etiology, including previous treatments.
2. Apply oxygen
3. When there are clinical signs of shock or developing respiratory symptoms as stridor, administer the following medicine:
   Adults- adrenaline 0.5 ml intramuscularly in a solution of 1:1000
   Children – 0.01 mg/ml/kg but maximum up to 0.3 ml of adrenaline intramuscularly in a solution of 1:1000
4. In the case of respiratory symptoms keep the patient in an upright sitting position, in the case of shock assume a lying position with elevated lower limbs. Secure intravenous access via cannula for the patient – infusion of physiological solution.
5. If there is no clinical improvement, give the same amount of adrenaline as the first time.
6. Give 10-20 mg of chlorpheniramin (antihystamicum) intramuscularly or slowly intravenously.
7. In all serious cases and in the cases of patients with bronchial asthma give 100 – 500 mg hydrocortisone intra intramuscularly or slowly intravenously.
   If the clinical sympthomathology of the shock does not respond to the treatment, it is imperative to give infusion of 1 – 2 l of physiologic solution quickly.

Source: Gazdík F., Gazdíková K., Dep. Of Immunology and Immunotoxicology, Scientific Research Base SZU – ÚPKM Bratislava.

Emergency package

Adrenaline 1:1000 / 1 ml
Dithiadent injection
Hydrocortisone in
Physiologic solution 500 ml
Infusion set
Ambulatory pack – securing breathing functions.