Anaphylactic shock is an allergic reaction that causes edema, also known as swelling of the airways. It is one of the most frightening types of shock because the airway is being occluded making breathing extremely difficult for the patient. Insect stings, drugs dyes, and foods such as shellfish are the most common causes of anaphylaxis. If emergency medical treatment is not rendered, the airway completely shut down, causing death.
Airway Management
Because the airway continues to swell and closes off during the reaction, keeping the airway open is the highest priority for anaphylactic shock. Swelling of the airway can progress and cause the tongue to swell as well. The swelling can occur rapidly, and the patients can decompensate very quickly. These patients should receive high levels of oxygen as soon as possible. Oxygen by a mask may be helpful initially, but due to the rapid swelling, a patient in anaphylactic shock needs to be connected to a mechanical breathing machine.
Fluid Rehydration
During an anaphylactic reaction, there is massive vasodilation of the blood vessels which causes fluids to shift and blood pressure to drop. Rehydration helps maintain normal blood pressure during anaphylaxis.
Medications
A combination of medications may be used to treat anaphylactic reactions. Epinephrine may be used to dilate the airways and ease the flow of air in and out of the lungs. According to "Sheehy's Manual of Emergency Care," inhaled bronchodilators are used also to dilate the small airways and decrease spasms, which can cause narrowing in the airways. Inhaled bronchodilators are given through a breathing machine that creates a mist for the patient to inhale. Steroid medications are used to help relax the smooth muscles in the lungs and decrease the inflammation caused by the reaction.
Cardiopulmonary Resuscitation
In instances where the airway has been occluded and oxygen has not been delivered to the heart, lungs, brain and other organs, the person will require cardiopulmonary resuscitation (CPR). In any situation where a person's airway is compromised and she is experiencing breathing difficulties, emergency care is required immediately.
References
- "Clinical Diagnosis & Treatment Emergency Medicine"; McGraw Hill; 2008
- "Sheehy's Manual of Emergency Care"; Elsevier Mosby; 2005
